{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:39:59Z","timestamp":1787787599071,"version":"build-2784847793"},"reference-count":30,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom"],"abstract":"<jats:p>Introduction: Borderline personality disorder (BPD) research is scarce. This study quantified risks of physical-diseases and assessed mortality patterns in individuals with BPD. Methods: This retrospective population-based cohort study investigated individuals with a first-recorded diagnosis of BPD in 2006\u20132021, utilizing a medical-record database of public healthcare services in Hong Kong. Individuals without mental-disorders attending primary care clinics in the study period served as unexposed comparison (i.e., primary care clinics [PCCs] cohort). We estimated risks of physical-diseases and all-cause and cause-specific mortality using Cox-proportional hazards-regression models, and calculated excess life-years lost (LYLs). Results: This analysis included 3,092 patients with BPD and 902,927 individuals in the PCC cohort. BPD was associated with increased risks of a wide-spectrum of physical diseases, with the highest hazards ratio (HR) for epilepsy (7.58 [95% confidence intervals: 5.33\u201310.79]). HRs for other physical-diseases ranged from 1- to 3-fold higher than the PCC cohort. Individuals with BPD experienced elevated risk of all-cause (5.65 [4.83\u20136.61]), natural-cause (2.02 [1.56\u20132.62]) and external-cause mortality (30.35 [23.52\u201339.17]), with suicide and cardiovascular diseases as the leading contributors. External causes accounted for 40.4% of deaths in BPD, while natural-causes explained 37.3%. The excess LYL for BPD was 13.01 years (9.35\u201315.52). The association between BPD and physical-diseases generally became statistically nonsignificant among males but remained significantly elevated among females. BPD-associated all-cause mortality risk was higher in females than males. Statistically significant associations between BPD and physical-diseases were predominantly observed in individuals with BPD diagnoses at younger-ages. Conclusion: BPD is associated with increased risk of physical-diseases, excess mortality and reduced life expectancy. Suicide-prevention strategies and physical-health monitoring are urgently warranted to reduce physical-health disparities and premature-mortality in BPD.<\/jats:p>","DOI":"10.1159\/000551534","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:01:10Z","timestamp":1773766870000},"page":"1-11","source":"Crossref","is-referenced-by-count":1,"title":["Association of Borderline Personality Disorder with Physical Diseases and Mortality: A 16-Year Population-Based Electronic Health-Record Cohort Study in Hong Kong"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7172-7579","authenticated-orcid":false,"given":"Joe Kwun","family":"Nam Chan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan Cheuk","family":"Yin Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corine Sau","family":"Man Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa Ramesh","family":"Mahboobani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kam Ming","family":"Ku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3581-8895","authenticated-orcid":false,"given":"Wing Chung","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21156"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1177\/0706743717700818"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.149583"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1192\/pb.27.11.401"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61995-4"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-022-01503-z"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1521\/pedi_2018_32_403"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-005-0593-7"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-005-0941-y"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2011.06.002"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.18m12436"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796021000305"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2020.248"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbaa137"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7954-12-11"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1192\/bjpo.bp.115.000356"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7357"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(17)30429-7"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1915784"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1002\/j.2051-5545.2011.tb00036.x"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2012.05.001"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003976"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-002808"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0279015"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00757-8"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2014.09.021"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32316-5"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-025-02887-4"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30004-3"}],"container-title":["Psychotherapy and Psychosomatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000551534","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:01:09Z","timestamp":1778515269000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000551534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":30,"URL":"https:\/\/doi.org\/10.1159\/000551534","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.31725202","asserted-by":"subject"}]},"ISSN":["0033-3190","1423-0348"],"issn-type":[{"value":"0033-3190","type":"print"},{"value":"1423-0348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}