Examining the association among eating disorders and borderline personality disorder: evidence from youth in Saudi Arabia.

BACKGROUND

Borderline Personality Disorder (BPD) is a complex psychiatric condition manifest by persistent instability in emotions, relationships, self-perception, and behavior. Eating disorders (EDs) are multifaceted neuropsychiatric conditions involving dysfunctional eating behaviors and psychological impairments, leading to adverse health outcomes and reduced quality of life. They are also associated with some of the highest mortality rates in psychiatry. EDs are typically classified to three main types: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Personality disorders are reflected as potential risk factors in the development of EDs. This study aimed to investigate the association between EDs and BPD among youth in Saudi Arabia.

METHODS

A total of 433 participants aged 18-34 were included in this study. The research employed a quantitative, cross-sectional design, conducted between September and November 2024. Data were collected via an online questionnaire comprising three sections: demographic and health-related information, the McLean Screening Instrument (MSI-BPD) for BPD, and the Eating Disorder Questionnaire-Online (EDQ-O) for EDs. The design aimed to validate self-reported BPD symptoms and explore their association with EDs.

RESULTS

The majority of the participants were female and educated Saudi persons who had no chronic illnesses; a notable 22.2% reported a formal diagnosis of BPD. The prevalence of EDs among the participants was found to be 67.9%. The findings revealed that BED was the most prevalent EDs among participants (45.03%), followed by BN at 22.17%, while AN was the least common (0.69%), indicating a higher occurrence of BED in the studied population. MSI-BPD screening results showed that 150 participants (34.64%) tested positive for BPD, with a higher prevalence among females (37.17%) compared to males (18.64%). A notably higher prevalence of EDs, particularly BED (74.67%) and BN (42.67%), was observed among participants with BPD, while AN remained rare in both groups. Pearson correlation analysis revealed statistically significant correlations (p < 0.01) between BPD and each EDs subtype (AN, BN, and BED), and the overall EDs symptom score.

CONCLUSION

This study indicates a notable comorbidity between BPD and EDs, particularly BED and BN, reinforcing the strong tendency of these disorders to co-occur.