Cognitive functioning of patients with borderline personality disorder

TL;DR

This study explores cognitive functioning in Russian patients with borderline personality disorder, finding significant impairments in memory and processing speed.

Contribution

The study is the first to investigate neurocognitive profiles of BPD patients in Russia, revealing impairments and symptom correlations.

Findings

33.3% of BPD patients showed neurocognitive impairments, particularly in working memory and verbal memory.

Higher BPD symptom severity correlated with lower composite cognitive scores.

Patients with higher BPD scores had significantly lower cognitive performance on multiple BACS subscales.

Abstract

The neurocognitive deficit model as a characteristic of patients with borderline personality disorder (BPD) has been the focus of research for the past 20 years. However, no such studies have been performed in Russia.

The aim of the present study was to investigate the neurocognitive profile of patients with BPD.

Fifty patients with BPD (according to DSM-V criteria) in stable mental state (72% women; mean age 22.44±4.32) were examined. BPD symptom severity was assessed using the Borderline Personality Disorder Questionnaire (PBQ-BPD), which was validated in the Russian population (34 points or more indicated a higher probability of BPD diagnosis). The Brief Assessment of Cognition in Schizophrenia (BACS) was used to assess cognitive function (in order to use these data for differential diagnosis with schizophrenia spectrum disorders). The study was approved by the ethical committee of Saint Petersburg State University.

On the PBQ-BPD results, 38% of patients (n=19) scored over 34 points, despite being stable. BACS subscales T-scores (presented as median [Q1; Q3]) were within normal limits (Verbal memory - 49.81 [46.56; 53,06]; Working memory - 43.73 [38.0; 47.50]; Motor function - 44.08 [41.0; 47.25]; Coding - 45.56 [42.50; 48.63]; Verbal fluency - 48.14 [46.0; 52.0]; Tower of London test - 52.33 [47.0; 57.0]). A number of patients had low scores on the BACS subscales (T-score < 40), particularly working memory (33.3%), coding (20.8%), and verbal memory (18.8%). The BACS Composite T Score (46.02 [43.65; 48.39]) correlated with the PBQ-BPD score (32.00 [27.00; 36.00]; r=-0.316; p=0.028). To better characterize the cognitive functioning of patients with BPD, patients were divided into two groups: those who scored less than 34 on the PBQ-BPD (group 1) and those who scored more than 34 on the PBQ-BPD (group 2). Group 2 patients had a lower BACS Composite T-score (42.32 [38.06; 46.58]; 48.45 [45.87; 51.03]; p=0.009) and nominally lower mean scores on all BACS subscales, compared with Group 1 patients. We found significant differences in T-scores values on the Working Memory subscale (Group 1 - 45.0 [41.0; 49.0]; Group 2 - 38.0 [33.0; 43.5], p=0.003), Verbal Fluency (49.0 [47.25; 53.75]; 48.0 [44.0; 49.0]; p=0.047), Tower of London Test (57.0 [52.0; 57.0]; 48.0 [42.0; 57.0]; p=0.036).

Neurocognitive impairment was detected in 33.3% of patients with BPD. The dominant cognitive impairments in the patients were decreased working and verbal memory and information processing speed. The severity of BPD symptoms has been confirmed to correlate with the neurocognitive functioning of these patients.

None Declared