Axis I Comorbidity in Hospitalized Adolescents with
Borderline Personality Disorder
Carolyn Ha, B.S.1 and Carla Sharp, Ph.D.1
University of Houston, Department of Psychology
Developmental Psychopathology Lab
BACKGROUND
 Patients with Borderline Personality Disorder (BPD)
place a significant burden on mental health services
(Bender et al., 200)
 Axis I comorbidity in adult inpatients with BPD (Zanarini
et al., 1998; Zimmerman & Mattia, 1999)
 Downward extension to inpatient adolescents
 Goal: Examine comorbidity of Axis I disorders in a
sample of inpatient adolescents diagnosed with BPD
compared to a group of psychiatric controls.
 Hypothesis: Patients with BPD would have
significantly more Axis I psychopathology (mood, anxiety,
substance abuse, oppositional defiant disorder, and
conduct disorder) when compared to a psychiatric control
group.
 n = 62 BPD patients (28% of sample)
 n = 163 Psychiatric control
 No significant differences between both groups in
terms of demographics except for gender:
Axis I Psychopathology
• Ethnicity: Caucasian 85.5% vs 92.6%; χ2 = 2.77,
 Diagnostic Interview Schedule for Children
p = .099
(NIMH-DISC-IV; Shaffer, Fischer, Lucas, Dulcan, &
• Age: (t = -1.21, p = .228), IQ (t = .548, p = .585)
Schwab-Stone, 2000)
• Global Assessment of Functioning (GAF) scores
 CRAFFT Substance screen (Kinght et al., 2002)
at admission: (t = 1.76, p = .08)
• Gender: BPD (83.9%) vs psychiatric control
(50.3%) were females (χ2 = 21.007, p < .001)
Table 2. Comparison of adolescents with BPD and psychiatric controls on Axis I disorders.
Axis I Disorder
METHODS
Participants
 Ages 12-17
 Inpatient adolescent unit
 Consecutive admissions
 N = 225
Table 1. Demographics and characteristics of full sample.
BPD
Age
IQ
GAF
Admission
Discharge
Sex
Males
Females
Ethnicity
Caucasian
Non-Caucasian
BPD diagnosis
Previous Hospital (1-6)
History of Medical Prob
History of Psych Prob
Sexual trauma
Lifetime Suicide Attempts
Psychiatric
Control
M
SD
M
SD
15.65 1.42 15.39 1.39
106.28 14.75 107.60 1.19
36.52
49.57
%
7.35
6.83
N
38.38
50.98
%
7.0
5.69
N
16.1
83.9
10
52
49.7
50.3
81
82
85.5
15.5
27.6
54.1
48.4
98.4
31.6
47.5
53
9
62
33
30
60
18
28
92.6
7.4
72.4
48.8
47.2
96.9
15.4
35.5
151
12
163
79
77
158
21
55
RESULTS
Measures
Borderline Personality Disorder
 Childhood interview for borderline personality
disorder (CI-BPD; Zanarini, 2003)
Mood D/O
MDD
Dysthymia
Hypomanic
Manic
Anxiety D/O
GAD
Agoraphobia
OCD
Panic Disorder
PTSD
SAD
Social Phobia
Specific Phobia
Eating D/O
Anorexia
Bulimia
Externalizing D/O
ADHD
ODD
CD
BPD
(n = 62)
N
39
32
2
4
4
50
13
7
25
13
9
13
12
18
6
5
1
36
17
28
24
%
68.4
55.2
3.4
6.9
6.9
84.7
22
35
42.4
22
15.3
48.1
20
30.5
54.5
8.5
1.7
61
28.8
47.5
40.7
Psychiatric Control
(n = 163)
N
87
51
1
2
6
112
13
13
29
17
7
14
26
17
5
5
0
54
24
20
23
%
56.1
33.1
.60
1.3
3.9
71.8
8.3
8.3
18.5
10.9
4.5
9
16.6
10.9
45.5
3.2
0
35
15.6
13
14.8
Chi-Square Analysis
χ2 (df = 1)
2.61
8.60
2.37
4.801
.84
3.86
7.66
.656
13.07
4.42
7.29
6.38
.356
12.08
4.23
2.64
2.64
11.78
4.80
29.04
16.65
p
.106
.003
.124
.028
.358
.049
.006
.418
>.001*
.035
.007
.012
.551
.001*
.040
.104
.104
.001*
.028
>.001*
>.001*
CONCLUSION
 Consistent with adult literature, inpatient adolescents with BPD have significantly more comorbid
Axis I disorders .
 Further bolsters findings that BPD in adults and adolescents is comparable.
 Importance of assessing for BPD in adolescence.