Current research indicates that personality disorders affect about 12% of the general population and constitute a significant mental health issue (Zanarini, 2005a). Recent studies have found that personality disorders (PDs) are more powerful predictors of quality of life than any one of the following: (1) socio-demographic variables; (2) Axis I disorders; and/or (3) somatic health (Zanarini, 2005a). It is also well known that patients with personality disorders make extensive use of mental health facilities and have more extensive histories of inpatient and outpatient treatment when compared to patients presenting only with Axis I disorders such as major depression (Zanarini, 2005a). All of the above highlight the importance of considering personality disorders in treatment planning and management of patients with dual diagnosis (Zanarini, 2005a).
Although it is generally recognized that personality disorders have a poorer response to treatment across all treatment modalities, there are a number of emerging findings that suggest more optimistic outcomes to treatment and management (Zanarini, 2005a). Most notably, emerging patterns indicate that personality disorders are not as stable as initially thought and studies indicate that they tend to go into remission at a quicker pace than expected (Zanarini, et al., 2007). It also appears that certain aspects of personality disorder are more amenable to treatment (Zanarini, et al., 2007). Further, there is now more evidence to suggest that borderline personality disorder (BPD) responds relatively well to treatment (Zanarini, et al., 2007).
Although borderline patients are very difficult to work with and pose many dilemmas for the treatment process, evidence suggests that they have a reasonably good prognosis when compared to other PDs and anxiety disorders (Zanarini, et al., 2005).