1

Review of Journal Article: Relationship Between Psychiatric Morbidity and Substance

Dependence in Patients with Borderline Personality Disorder

 2

Summary

Borderline personality disorder is a mental health issue that affects as much as two

percent of the general population and the disorder’s prevalence in a clinical setting is even larger

with fifteen percent of psychiatric inpatients meeting the criteria for diagnosis of borderline

personality disorder. (Sureka, 2018). This prevalence of borderline personality disorder puts a

burden on the health care facilities that these individuals attend as it takes more resources to treat

those individuals. Borderline personality disorder is associated with functional impairment and

high chances of co-occurring disorders (Sureka, 2018). These co-occurring disorders are not

specific to a small amount of disorders. Attention-deficit, mood, anxiety, substance abuse or

dependency, and eating disorders are all common with roughly fifty percent of individuals

diagnosed with borderline personality disorder also being diagnosed with one if not more of

these disorders (Sureka, 2018). The prevalence of these co-occurring disorders adds onto the

difficulty of treating the individuals with borderline personality disorder. The current study

investigates the prevalence of psychiatric morbidity in male prisoners with borderline personality

disorder and the relation between psychiatric morbidity and substance dependence (Sureka,

2018).

To accomplish this the cross-sectional study investigates six hundred twelve male

participants from Central Jail Hospital in New Delhi, half of which were the control participants

and half of which were the study participants (Sureka, 2018). The study used the following tools

to gather information: international personality disorder examination, basic socio-demographic

performa, the mini-mental state examination, schedule for clinical assessment in

neuropsychiatry, and ICD-10 criterion. (Sureka, 2018). After gaining consent from the
 3

participants the assessment tools were used to gather information by trained psychiatrists

(Sureka, 2018).

The study found that between the control and study groups there was no significant

difference in demographic variables such as, age, education, or occupation (Sureka, 2018). The

study also found that the substance dependence score was higher for those individuals with

psychiatric morbidity (Sureka, 2018). Between the control and study groups there was a

significant difference in psychiatric morbidity rates, 68.6% in the study group and only 29.7% in

the control group (Sureka, 2018).

Critique

This study shows that there is a connection between borderline personality disorder,

psychiatric morbidity, and substance dependence. Substance users suffered from higher rates of

psychiatric morbidity which then affected them with earlier onset and increased severity of

substance dependence. Borderline personality disorder is already considered difficult to treat and

the psychiatric morbidity and substance use furthers the difficulty of treating those with the co-

occurring disorders.

Due to the study’s setting of a prison it could have had effects on the results. Interviewing

participants and their family members could have possibly provided important additional

information but due to the setting that was not possible. The study was required to limit the

inclusion to only males as they are much larger in number and an adequate sample size could not

be achieved if the study included females. The limitations of the participants and setting also

prohibit these findings from being generalized for a general population. Many of the tools used
 4

for assessment were based on self-reporting and that could have caused some issues as people try

and negate any substance use, they had done

A large issue with the study as a whole is that many of the references are dated, most

being older than 2010 and a significant amount being older than 2000. This is particularly

evident in the tools used for examination of the participants were almost all of the tools were

dated before 2000. This can cause an issue in accuracy and reliability as the assessments may

have wrong information regarding what they are examining and thus would provide wrong

information to the researchers.

 5

References

Sureka, P. (2018). Relationship Between Psychiatric Morbidity and Substance Dependence in

Patients with Borderline Personality Disorder Activitas Nervosa Superior, (60) 59-67.

doi:10.1007/s41470-018-0021-8