{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:55:10Z","timestamp":1793141710680,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>The purpose of this study is to detail the long\u2010term course of substance use disorders (SUDs) among patients with borderline personality disorder (BPD) and subjects with other personality disorders (OPD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred and ninety patients with BPD and 72 subjects with OPD were assessed at baseline and 12 contiguous waves of follow\u2010up as part of the McLean Study of Adult Development (MSAD). The SCID\u2010I for DSM\u2010III\u2010R Axis I disorders was administered 13 times (at baseline admission and at 12 follow\u2010up periods). Kaplan\u2013Meier analyses were used to assess time\u2010to\u2010remission (2\u201312 years in length), time\u2010to\u2010recurrence (2\u201312 years after first remission), and cumulative time\u2010to\u2010new onsets of alcohol and drug use disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both study groups achieved high rates of remission (ranging from 12\u2010year long to 2\u2010year long) from alcohol use disorder (AUD) (BPD: 64%\u201391%; OPD: 80%\u2013100%) and drug use disorder (DUD) (BPD: 71%\u2013100%; OPD: 75%\u2013100%). Recurrences (following 12\u2010year long and 2\u2010year long remissions) of AUD (BPD: 24%\u201363%; OPD: 46%\u201370%) and DUD (BPD: 28%\u201367%; OPD: 0%\u201338%) were not uncommon. Cumulative rates of new onsets during the 24 years of prospective follow\u2010up of AUD (BPD: 5%\u201327%; OPD: 2%\u201310%) and DUD (BPD: 5%\u201321%; OPD: 7%\u201318%) were less common.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Remissions of alcohol and drug use disorders among borderline patients are very common but recurrences are not uncommon. Results also suggest that new onsets of these disorders are relatively rare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>The course of SUDs in those with BPD is more complex than found in prior shorter\u2010term studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.70012","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:49:13Z","timestamp":1740617353000},"page":"422-432","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The 24\u2010year course of substance use disorders in patients with borderline personality disorder and personality\u2010disordered comparison subjects"],"prefix":"10.1111","volume":"34","author":[{"given":"Mary C.","family":"Zanarini","sequence":"first","affiliation":[{"name":"Laboratory for the Study of Adult Development, McLean Hospital Belmont Massachusetts USA"},{"name":"Harvard Medical School Boston Massachusetts 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