Risk of Teenage Pregnancy among Adolescents with Borderline Personality Disorder: A Nationwide Longitudinal Study

Mu-Hong Chen ； Shih-Jen Tsai

《台灣精神醫學》 35卷1期 (2021/03) Pp. 26-31

https://doi.org/10.4103/TPSY.TPSY_6_21

摘要

Background: Evidence suggested that borderline personality disorder (BPD) is related to the increased likelihood of risky sexual behaviors and that BPD is one of the most important risk factors of teenage pregnancy among adolescents. But whether adolescent BPD is independently associated with teenage pregnancy remains uncertain. Methods: We enrolled 809 adolescent girls with BPD and 8,090 without BPD between 2001 and 2009 and followed them up to the end of 2011 for the identifying any teenage pregnancy and repeated teenage pregnancy. Comorbidities of depressive disorder, bipolar disorder, as well as alcohol and substance use disorder were assessed. Psychotropic medications including antidepressants, mood stabilizers, and second-generation (atypical) antipsychotics were also identified. Results: Using Cox regression analyses with an adjustment of demographic characteristics, psychiatric comorbidities, and psychotropic medications showed that adolescents with BPD had significant increased risks of any teenage pregnancy (hazard ratio [HR] = 14.53, 95% confidence interval [CI] = 9.89-21.37, p ＜ 0.05), and repeated teenage pregnancy (HR = 30.43, 95% CI = 17.32-53.45, p ＜ 0.05) during the follow-up compared with non-BPD controls. Psychotropic medications were not significantly associated with the risks of any teenage pregnancy and repeated teenage pregnancy. Discussion: Adolescent BPD was an independent risk factor of any teenage pregnancy and repeated teenage pregnancy, regardless of the comorbidities of alcohol and substance use disorders. Whether the prompt intervention toward adolescent BPD may reduce the risks of any teenage pregnancy and repeated teenage pregnancy would need further investigation.

關鍵字

adolescents ； borderline personality disorder ； early pregnancy ； teenage pregnancy

參考文獻

Kernberg OF, Michels R: Borderline personality disorder. Am J Psychiatry 2009; 166: 505-8.

Leichsenring F, Leibing E, Kruse J, et al.: Borderline personality disorder. Lancet 2011; 377: 74-84.

Lieb K, Zanarini MC, Schmahl C, et al.: Borderline personality disorder. Lancet 2004; 364: 453-61.

Guilé JM, Boissel L, Alaux-Cantin S, et al.: Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies. Adolesc Health Med Ther 2018; 9: 199-210.

Penner F, Wall K, Jardin C, et al.: A study of risky sexual behavior, beliefs about sexual behavior, and sexual self-efficacy in adolescent inpatients with and without borderline personality disorder. Personal Disord 2019; 10: 524-35.