Prevalence and psychological correlates of borderline personality traits among medical students in Egypt: a multicenter cross-sectional study.

BACKGROUND: Borderline personality traits are prevalent among university students and can significantly impair their emotional and interpersonal functioning. This study aimed to assess the prevalence of borderline personality traits and their psychological correlates among medical students in Egypt. METHODS: A multicenter cross-sectional study was conducted during the 2024/2025 academic year, involving 1,293 medical students from eight Egyptian universities. Borderline personality traits were screened using the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), a self-report screening tool derived from the BPD module of the Diagnostic Interview for DSM-IV Personality Disorders. While anxiety symptoms were assessed with the Generalized Anxiety Disorder-2 (GAD-2), and depressive symptoms were assessed with the Patient Health Questionnaire-2 (PHQ-2), respectively. Pearson’s correlation and multivariable binary logistic regression analyses were performed to identify factors associated with borderline personality traits. RESULTS: Participants reported an average of 3.85 traits on the MSI-BPD, with 18.5% screening positive for clinically significant borderline personality traits. The most prevalent symptoms were mood instability (53.2%) and chronic feelings of emptiness (47.0%), while 17.2% reported suicidal ideation. Correlation analyses showed significant positive relationships between borderline personality traits and both depression (r = 0.52, p < 0.001) and anxiety (r = 0.61, p < 0.001). Multivariable regression identified three significant predictors of positive borderline personality traits screening: family history of mental illness (Adjusted Odds Ratio (AOR) = 2.17, 95% CI: 1.57, 3.01), anxiety symptoms (AOR = 1.38, 95% CI: 1.25, 1.53), and depressive symptoms (AOR = 1.38, 95% CI: 1.24, 1.54). CONCLUSION: Borderline personality traits are prevalent among Egyptian medical students and are strongly associated with anxiety, depression, and familial mental health history. These findings highlight the need for early screening and targeted interventions to support students at risk. CLINICAL TRIAL NUMBER: Not applicable.