Prevalence and Onset

How do we know how prevalent BPD is?

First, we should note that in the early 1990s BPD was not recognized as a common disorder. Now it is.

A number of studies have been performed in the USA to determine prevalence. Some found that 1.8% of Americans meet the criteria, while others suggested a range of 2-4% or even almost 6%. Even the lowest estimate finds that BPD is about as common as Bi-Polar I and more common than Schizophrenia, both of which are far better known.

Up-to-Date Research:

Summing up the conservative end, Zanarini stated in 2016: 1.8% of Americans meet criteria. (Zanarini McLean Webinar–BPD Patient and Family Education Initiative, “The Long-Term Course of Borderline Personality Disorder,” Originally aired Wednesday, February 3, 2016, accessed at

In an earlier 2003 study Zanarini had stated that clinical experience suggests that BPD is often underdiagnosed in many treatment settings, so 1.8% may be low. (Zanarini et al. “A SCREENING MEASURE FOR BPD: THE MCLEAN SCREENING INSTRUMENT FOR BORDERLINE PERSONALITY DISORDER (MSI-BPD)” Journal of Personality Disorders, 17[6], 568-573, 2003.)

Gunderson, championing the middle road, states that BPD is the most common of the personality disorders, with a prevalence rate of approximately 2–4% in the general population, accounting for 20% of people receiving inpatient mental health care and 15% of those receiving outpatient care. (Gunderson, J. [2011]. A BPD brief: An introduction to borderline personality disorder: Diagnosis, origins, course, and treatment. Retrieved from

Grant et al provide the highest figures:

“The results of a large, well-conducted study funded by the National Institute of Mental Health suggests that the lifetime prevalence rate of borderline disorder is 5.9% of the general population and appears to occur equally in men and women.” (Grant et al. “Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Borderline Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions” J Clin Psychiatry. 2008 Apr; 69[4]: 533–545. Summarized in Robert O. Friedel M.D., accessed at , January 17, 2019.)


BPD can be diagnosed as early as at 12 years old if symptoms persist for at least one year, according to the DSM-5. Most diagnoses, however, are made during late adolescence or early adulthood. “As Mayo Clinic psychiatrist Christopher Palmer notes, the condition may not manifest until adolescence—often with self-cutting, burning, or frank suicidal behavior—but it begins long before. ‘As children, they are hard to parent,’ he says. In the absence of exceptional parenting, they never achieve self-regulation or a stable sense of self and never learn to tolerate any distress.”(Elizabeth Svoboda, “The Chaos That Borderline Personality Can Generate,” Psychology Today, September 2, 2013)