borderline personality disorder

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Etiology

Epidemiology

Pathology

Clinical manifestations

  • emotional dysregulation
  • a pattern of unstable & intense interpersonal relationships characterized by alternations between extremes of idealization & devaluation
  • identity disturbance: persistent & markedly disturbed, distorted or unstable image or sense of self
  • impulsivity in at least 2 areas that are potentially self damaging; i.e financial affairs, sex, substance abuse, reckless driving, binge eating
  • feelings of depression: recurrent suicidal behaviors, gestures of threats or self-mutilating behavior (episodes may be short)
  • feelings of emptiness (episodes may be short)
  • affective instability due to a marked reactivity of mood (i.e. intense episodic dysphoria, irritability, or anxiety usually lasting only a few hours, rarely more than a few days)
  • inappropriate, intense anger or lack of control of anger; i.e. frequent displays of temper, constant anger, recurrent physical fights
  • transient, stress-related paranoid ideation or severe dissociative symptoms
  • no changes in sleep or appetite[4]
  • complaints about other health care providers, but you are different[3]

Differential diagnosis

Management

More general terms

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1101-1102
  2. 2.0 2.1 New AS Amygdala-prefrontal disconnection in borderline personality disorder Neuropsychopharmacology 2007, 32:1629 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17203018
  3. 3.0 3.1 3.2 Medical Knowledge Self Assessment Program (MKSAP) 14, 16, 17. American College of Physicians, Philadelphia 2006, 2012, 2015
  4. 4.0 4.1 4.2 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
    Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
    Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  5. Gunderson JG. Clinical practice. Borderline personality disorder. N Engl J Med. 2011 May 26;364(21):2037-42. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21612472
  6. Stevenson J, Meares R, Comerford A. Diminished impulsivity in older patients with borderline personality disorder. Am J Psychiatry. 2003 Jan;160(1):165-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12505816
  7. 7.0 7.1 NEJM Knowledge+ Psychiatry
  8. Borderline Personality Disorder http://www.nimh.nih.gov/publicat/bpd.cfm

Patient information

borderline personality disorder patient information