Dependent personality disorder (or DPD) is a personality disorder that frequently co-occurs with borderline personality disorder (BPD). What is DPD, and why do BPD and DPD overlap so frequently?
What Is Dependent Personality Disorder?DPD is a personality disorder characterized by a pervasive and excessive need to be taken care of. In the Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision), DPD is classified as one of the Cluster C, or anxious/fearful, personality disorders, along with avoidant and obsessive-compulsive personality disorder.
Individuals with dependent personalities tend to be very clingy, and have difficulties accomplishing tasks or making decisions without the help of others. They tend to feel inadequate and helpless, and can have problems in their relationships because of their near-constant need for support.
The Frequency of Co-Occurring DPD and BPD
While studies of the co-occurrence (also called comorbidity) of the personality disorders are fairly rare, a few researchers have examined the overlap between dependent and borderline personality. One study, conducted in a group of people with a history of mental health treatment, found that just over 50 percent of patients with BPD also meet criteria for DPD.
Another study that drew from a broader community sample had dramatically different results -- only about 3% of people with BPD also had dependent personality (but, in this study, about 45% of people with DPD met criteria for BPD).
Why so much overlap? It could be because some of the features of DPD are very similar to the features of BPD. For example, people with BPD experience rejection sensitivity –- they have a tendency feel desperate at even the slightest perceived rejection. Individuals with DPD may react similarly to criticism or perceived abandonment by loved ones.
What to Do If You or A Loved One Has DPD and Co-Occurring BPD
We do not yet have research trials to provide us sound evidence of the best treatment strategy for someone with comorbid borderline and dependent personality. However, because of the overlapping symptoms, it is likely that some of the treatments designed specifically to treat BPD may also provide relief for symptoms of DPD.
For example, Dialectical Behavior Therapy (DBT), Schema-Focused Therapy, and Transference-Focused Therapy all have treatment elements that focus on relationship problems. These may be appropriate treatment choices for someone with both BPD and DPD.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition. American Psychiatric Association: 2000.
Grant BF, Chou SP, Goldstein RB, et al. "Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Borderline Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions," Journal of Clinical Psychiatry, 69(4): 533-545, 2008.
Zanarini MC, Frankenburg FR, Dubo ED, Sickel AE, Trikha A, Levin A, Reynolds V. Axis II comorbidity of borderline personality disorder. Comprehensive Psychiatry, 39(5):296-302, 1998.