Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities

Purpose: In this study, we report prevalence rates of borderline personality disorder (BPD) and Axis I psychiatric and substance use disorders among randomly selected women who were experiencing episodes of homelessness in three US cities. Methods: The sample consists of 156 women, 79 from Omaha, NE, 39 from Pittsburgh, PA, and 38 from Portland, OR. It included 140 women from shelters and 16 women from meal locations. Latent class analysis was used to evaluate BPD symptoms. Results: A large majority of the women (84.6 %) met criteria for at least one lifetime psychiatric disorder, about three-fourths (73.1 %) met criteria for a psychiatric disorder in the past year, and 39.7 % met past month criteria for a psychiatric disorder. Approximately three-fourths of the sample (73.7 %) met lifetime criteria for at least two disorders, about half (53.9 %) met criteria for at least three lifetime disorders, and approximately one-third (39.1 %) met criteria for four or more disorders. Latent class analyses indicated that 16.7 % of the women could be categorized as low self-harm BPD and 19.9 % high self-harm BPD. Conclusions: In shelters and in treatment settings, these women will present with complex histories of multiple serious psychiatric disorders. They are highly likely to manifest symptoms of BPD, post-traumatic stress disorder, and substance abuse disorders in addition to other psychiatric symptoms which will add to clinical complications.