Better than expected: improvements in borderline personality disorder in a 3-year prospective outcome study.

We report on the symptomatic outcome, predictors of outcome, and different courses of change in a 3-year prospective, naturalistic study of 37 female patients with borderline personality disorder (BPD). Results show significant improvements in several areas and no significant deterioration. Most patients showed a course of erratic improvement, and only a few showed decline over time. The main baseline predictors of good 3-year outcome were low obsessiveness and phobia symptoms. Results from the Global Assessment Scale (GAS) in this study, like five prior studies, demonstrate that by 3 years BPD patients can be expected to move from a poor to a fair level of functioning. It is suggested that over a 3-year period, improvements may be expected from BPD patients. Prior reports of poor short-term outcome may have been the result of different diagnostic criteria and outcome measurement. Limitations of this study and the need for tentative interpretation of its results are also discussed.