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Letter to the Editor   |    
Substance Abuse and Borderline Personality Disorder
RICHARD M. WAUGAMAN, M.D.
Am J Psychiatry 2005;162:1759-a-1759. doi:10.1176/appi.ajp.162.9.1759-a

To the Editor: The important study by Mary C. Zanarini, Ed.D., et al. (1) demonstrated the central role of substance abuse in the course of borderline personality disorder. Although the authors stated that "this finding runs counter to clinical lore" (p. 2112), they failed to mention that a study described in one of their references (2, p. 211) found that substance abuse accounted for more of the variance in outcome for female patients with borderline personality disorder than any of the seven other factors that were studied. Taken together, these data underline the sound recommendation of Dr. Zanarini et al. that substance abuse disorders in patients with borderline personality disorder need to be a crucial focus of treatment efforts.

Zanarini MC, Frankenburg FR, Hennen J, Reich DB, Silk KR: Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. Am J Psychiatry  2004; 161:2108–2114
[PubMed]
[CrossRef]
 
Stone MH: The Fate of Borderline Patients. New York, Guilford, 1990
 
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References

Zanarini MC, Frankenburg FR, Hennen J, Reich DB, Silk KR: Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. Am J Psychiatry  2004; 161:2108–2114
[PubMed]
[CrossRef]
 
Stone MH: The Fate of Borderline Patients. New York, Guilford, 1990
 
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