Employment in borderline personality disorder.

A number of studies in the literature have explored employment outcomes in patients with borderline personality disorder. However, after imposing our exclusion criteria, we located only 11 viable studies, published between the years 1983 and 2010. Individual studies examined employment outcomes in 8 to 249 individuals, but eight studies consisted of 33 participants or less. At baseline, participants were recruited from various locales, including hospital settings (7 studies), outpatient settings (2 studies), day treatment (1 study), and a college campus (1 study). The follow-up periods in these studies ranged from 1 to 27 years. Three studies compared participants with borderline personality disorder to a cohort of individuals with other types of psychopathology whereas only two studies used a normative comparison group. Given a host of potential limitations, findings cautiously suggest that nearly half of individuals with borderline personality disorder remain unemployed at follow-up, and of these, only a portion are self-supporting; 20 to 45 percent subsist on disability. However, several studies found modest employment gains among some individuals with borderline personality disorder, and one study developed a work/school acclimatization program, which meaningfully improved employment outcomes. This general area warrants further research to clarify the explicit employment outcomes of patients with borderline personality disorder.