The British Journal of Psychiatry (2008) 192: 118-123. doi: 10.1192/bjp.bp.107.035782
© 2008 The Royal College of Psychiatrists
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Attention-deficit hyperactivity disorder as a potentially aggravating factor in borderline personality disorder

Alexandra Philipsen, MD

Department of Psychiatry and Psychotherapy, University Medical Center, Freiburg

Matthias F. Limberger, MA

Department of Psychosomatic Medicine, Central Institute of Mental Health, Mannheim

Klaus Lieb, MD and Bernd Feige, PhD

Department of Psychiatry and Psychotherapy, University Medical Center, Freiburg

Nikolaus Kleindienst, PhD, Ulrich Ebner-Priemer, PhD, Johanna Barth, MA, Christian Schmahl, MD and Martin Bohus, MD

Department of Psychosomatic Medicine, Central Institute of Mental Health, Mannheim, Germany

Correspondence: Professor Martin Bohus, Central Institute of Mental Health Mannheim, J5, D-68159 Mannheim, Germany. Email: martin.bohus{at}zi-mannheim.de

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Clinical experience suggests that people with borderline personality disorder often meet criteria for attention-deficit hyperactivity disorder (ADHD). However, empirical data are sparse.

Aims

To establish the prevalence of childhood and adult ADHD in a group of women with borderline personality disorder and to investigate the psychopathology and childhood experiences of those with and without ADHD.

Method

We assessed women seeking treatment for borderline personality disorder (n=118) for childhood and adult ADHD, co-occurring Axis I and Axis II disorders, severity of borderline symptomatology and traumatic childhood experiences.

Results

Childhood (41.5%) and adult (16.1%) ADHD prevalence was high. Childhood ADHD was associated with emotional abuse in childhood and greater severity of adult borderline symptoms. Adult ADHD was associated with greater risk for co-occurring Axis I and II disorders.

Conclusions

Adults with severe borderline personality disorder frequently show a history of childhood ADHD symptomatology. Persisting ADHD correlates with frequency of co-occurring Axis I and II disorders. Severity of borderline symptomatology in adulthood is associated with emotional abuse in childhood. Further studies are needed to differentiate any potential causal relationship between ADHD and borderline personality disorder.


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