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SYSTEMATIC REVIEW article

Front. Psychiatry
Sec. Personality Disorders
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1490157

Prevalence of homosexual and bisexual orientation in patients with borderline personality disorder and associated factors - a systematic review and meta-analysis

Provisionally accepted
Ying Chi Camille Shu Ying Chi Camille Shu 1Ka To Lau Ka To Lau 1Cyrus SH Ho Cyrus SH Ho 2*
  • 1 Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Region, China
  • 2 Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

The final, formatted version of the article will be published soon.

    This meta-analysis aimed to quantitatively evaluate the association between homosexual and bisexual orientation and borderline personality disorder (BPD), including factors contributing to the association and clinical outcomes of homosexual and bisexual patients with BPD. We systematically searched PUBMED, PsycINFO, Cochrane Library, MEDLINE, EMBASE and Web of Science for cross-sectional or cohort studies comparing the prevalence of homosexual and bisexual orientation amongst patients with BPD and controls. Our search identified 7 eligible studies, with a total sample case of 636 subjects with BPD and 535 subjects without BPD. Patients with BPD had a significantly higher likelihood of homosexual and bisexual orientation (Risk ratio [RR] 3.39, 95%CI 1.88-6.12) with a pooled prevalence of 28% (95% CI 0.24-0.31; I 2 73%; 7 studies, 1171 participants). Subgroup analyses validated that BPD was independently associated with higher prevalence of both homosexual (RR 8.51, 95% CI 3.36-21.54) and bisexual orientation (RR 3.82, 95% CI 1.81-8.04), but no gender difference was yielded. Childhood sexual abuse (CSA) was associated with the development of homosexual and bisexual orientation in patients with BPD. Poorer clinical outcomes, including physical and mental health, were associated with BPD status. Further studies are necessary to evaluate the feasibility and efficacy of sexual minority-specific treatment for these patients.

    Keywords: Meta-analysis, Borderline Personality Disorder, sexual orientation, Homosexuality, Bisexuality

    Received: 02 Sep 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Shu, Lau and Ho. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Cyrus SH Ho, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.