01.83
Borderline Personality Disorder
Patients with Borderline Personality Disorder sustain a pattern of
instability throughout their adult lives. They often appear to be in a crisis of
mood, behavior, or interpersonal relationships. Many feel empty and bored; they
attach them- selves strongly to others, then become intensely angry or hostile
when they believe that they are being ignored or mistreated by those they depend
on. They may impulsively try to harm or mutilate themselves; these actions are
expressions of anger, cries for help, or attempts to numb themselves to their
emotional pain. Although borderline patients may experience brief psychotic
episodes, these episodes resolve so quickly that they are seldom confused with
psychoses like Schizophrenia. Intense and rapid mood swings, impulsivity, and
unstable interpersonal relationships make it difficult for borderline patients
to achieve their full potential socially, at work, or in school
Borderline Personality Disorder runs in families. These people are truly
miserable and in some cases (up to 10%) complete suicide.
The concept of Borderline Personality Disorder was devised about the
middle of the 20th century. These patients were originally (and sometimes still
are) said to be on the borderline between neurosis and psychosis.
The existence of this borderline is disputed by many clinicians. As the
concept has evolved into a personality disorder, it has achieved remark- able
popularity, perhaps because so many patients can be shoehorned into its
capacious definition.
Although 1-2% of the general population may legitimately qualify for the diagnosis of Borderline Personality Disorder, it is probably applied to a far greater proportion of the patients who seek mental health care. It may still be the most over-diagnosed condition in DSM-IV. Many of these patients have Axis I disorders that are more readily treatable; these include Major Depressive Disorder, Somatization Disorder, and substance-related disorders.
See Criteria
Source
DSM-IV Made Easy: The Clinician's Guide to Diagnosis. James Morrison.