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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2011; 11: 158.
Published online 2011 September 30. doi:  10.1186/1471-244X-11-158
PMCID: PMC3202232
Copyright ©2011 Speranza et al; licensee BioMed Central Ltd.
ADHD in adolescents with borderline personality disorder
Mario Speranza,corresponding author1,2 Anne Revah-Levy,2,3 Samuele Cortese,4 Bruno Falissard,2 Alexandra Pham-Scottez,2,5 and Maurice Corcos2,6
1Centre Hospitalier de Versailles. Service de Pédopsychiatrie. Le Chesnay, France and EA40/47 UVSQ, France
2INSERM U669, Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France
3Centre de Soins Psychothérapeutiques de Transition pour Adolescents, Hôpital d'Argenteuil, F-95107, Argenteuil, France
4Institute for Pediatric Neuroscience, New York University Child Study Center. 215 Lexington Ave, 14th Floor. New York, NY 10016, USA
5Clinique des Maladies Mentales et de l'Encéphale, Hôpital Sainte-Anne, Paris, France
6Institut Mutualiste Montsouris, Département de Psychiatrie de l'Adolescent et du Jeune Adulte, Paris, France
corresponding authorCorresponding author.
Mario Speranza: msperanza/at/ch-versailles.fr; Anne Revah-Levy: anne.revah-levy/at/ch-argenteuil.fr; Samuele Cortese: samuele.cortese/at/gmail.com; Bruno Falissard: falissard_b/at/wanadoo.fr; Alexandra Pham-Scottez: a.pham/at/ch-sainte-anne.fr; Maurice Corcos: maurice.corcos/at/imm.fr
Received July 5, 2011; Accepted September 30, 2011.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
The aims of this study were to assess the prevalence of a comorbid Attention Deficit Hyperactivity Disorder (ADHD) diagnosis in Borderline Personality Disorder (BPD), and its impact on the clinical presentation of BPD in adolescents, and to determine which type of impulsivity specifically characterizes adolescents with BPD-ADHD.
Methods
ADHD diagnoses were sought in a sample of 85 DSM-IV BPD adolescents drawn from the EURNET BPD. Axis-I and -II disorders were determined with the K-SADS-PL and the SIDP-IV, respectively. Impulsivity was assessed with the BIS-11.
Results
11% (N = 9) of BPD participants had a current ADHD diagnosis. BPD-ADHD adolescents showed higher prevalence of Disruptive disorders (Chi2 = 9.09, p = 0.01) and a non-significant trend for a higher prevalence of other cluster B personality disorders (Chi2 = 2.70, p = 0.08). Regression analyses revealed a significant association between Attentional/Cognitive impulsivity scores and ADHD (Wald Z = 6.69; p = 0.01; Exp(B) = 2.02, CI 95% 1.19-3.45).
Conclusions
Comorbid ADHD influences the clinical presentation of adolescents with BPD and is associated with higher rates of disruptive disorders, with a trend towards a greater likelihood of cluster B personality disorders and with higher levels of impulsivity, especially of the attentional/cognitive type. A subgroup of BPD patients may exhibit developmentally driven impairments of the inhibitory system persisting since childhood. Specific interventions should be recommended for this subsample of BPD adolescents.
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