Neuropsychological deficits in BPD patients and the moderator effects of co-occurring mental disorders: A meta-analysis.

Studies have shown that patients with borderline personality disorder (BPD) have co-occurring disorders; literature has also suggested that BPD patients have impairments in neuropsychological functioning, as seen in a previous meta-analysis (Ruocco, 2005). This meta-analysis showed that neuropsychological functioning are marked areas of concern in BPD; however, this meta-analytic research did not assess the effects of co-occurring disorders on neuropsychological functioning in BPD patients. The current meta-analysis takes this into consideration and a systematic review of cross-sectional studies comparing neuropsychological performance of individuals with BPD with age-matched healthy comparison subjects was carried out. Potential moderators (i.e., age, gender, education level, and co-morbid mental disorders) were analyzed. Significant deficits were observed in the decision making, memory, executive functioning, processing speed, verbal intelligence, and visuospatial abilities. BPD patients with more education and with parents of a higher educational level had better neuropsychological functioning. Globally, BPD samples with a higher percentage of co-morbid personality disorders, major depression, eating disorders, or any substance abuse disorders performed worse than patients with a less percentage; however, anxiety disorders and PTSD co-morbidity did not affect the cognitive performance of the BPD group. Differences are seen dependent on neuropsychological domain and specific co-morbidity. These findings highlight the clinical relevance of characterizing cognitive functioning in BPD and the importance of considering demographic and clinical moderators in future analyses.