Epidemiology of borderline personality disorder in the general population: Prevalence, sociodemographic factors, and comorbidities - A systematic review and meta-analysis.

OBJECTIVE

Borderline Personality Disorder (BPD) is a severe mental health condition with significant public health relevance. Although traditionally viewed as more prevalent in clinical populations, its true prevalence and associated sociodemographic factors in the general population remain subject to debate. This systematic review aims to synthesize epidemiological evidence on the prevalence, sociodemographic correlates, and psychiatric comorbidities of BPD in community-based samples.

METHODS

A systematic literature search was conducted in PubMed and Web of Science Core Collection (2000-2024). Eligible studies assessed the prevalence of BPD, its sociodemographic correlates, and psychiatric comorbidities in community-based samples, using DSM-III-R, DSM-IV, or DSM-5 diagnostic criteria. Study quality was evaluated using the JBI Critical Appraisal Checklist for Prevalence Studies.

RESULTS

Twelve studies met the inclusion criteria. The pooled prevalence of BPD was 2.41 % (95 % CI: 1.70 %-3.40 %), with reported estimates across studies ranging from 0.7 % to 7.35 %, reflecting substantial heterogeneity in the literature. Although BPD has historically been considered more common in women, population-based data indicate a more balanced sex distribution. Prevalence tended to decrease with age and was associated with lower socioeconomic status, unemployment, and lower education levels. High psychiatric comorbidity was observed, with BPD emerging as the strongest independent predictor of suicide attempts.

CONCLUSIONS

BPD prevalence in the general population appears higher than previously estimated. Its strong association with sociodemographic disadvantage, psychiatric comorbidity, and increased suicide risk highlights the need for early detection and timely access to comprehensive, evidence-based treatment. Therefore, addressing diagnostic biases and improving access to mental health care are essential for reducing the long-term burden of BPD on both affected individuals and healthcare systems.