In the BPD only cohort, there were 11,007 inpatient admissions with a primary diagnosis of BPD. These patients had a similar LOS as seen in bipolar patients with BPD but lower mean total charges per inpatient admission. Despite a higher proportion of patients with major severity of illness and suicidality, the utilization of ECT was very low (0.6%). This could explain the discrepancy in hospitalization charges. Future studies should be conducted to evaluate the comorbidities that increase the chances of hospitalization in BPD patients.