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Borderline personality disorder

From Wikipedia
borderline personality disorder
type of disease
Subclass ofcluster B personality disorders Edit
Studied byPsychiatric Services, psychology, psychiatry Edit
Health specialtypsychiatry, clinical psychology Edit
Symptoms and signsemotional dysregulation, self-injury, impulsivity, dysphoria, anger Edit
Possible treatmentpsychotherapy, dialectical behavior therapy Edit
Drug or therapy used for treatmentquetiapine, aripiprazole, lamotrigine Edit
WordLift URLhttp://data.medicalrecords.com/medicalrecords/healthwise/borderline_personality_disorder_2 Edit
ICD-9-CM301.83 Edit
ICPC 2 IDP80 Edit

Borderline personality disorder (BPD), dem sanso know am as emotionally unstable personality disorder (EUPD), be a mental illness wey be characterized by a long-term pattern of unstable relationships, distorted sense of self, den strong emotional reactions.[1][2][3] Individuals often dey engage insyd self-harm den oda dangerous behavior.[4][5][6] Those wey be affected sanso fi struggle plus a feeling of emptiness, fear of abandonment, den detachment from reality. Symptoms fi be triggered by events dem consider normal to odas.[2] De behavior typically dey begin by early adulthood den dey occur across a variety of situations.[1] Substance abuse,[7][8] depression, den eating disorders[2] be commonly associated plus BPD. Approximately 10% of people wey be affected die by suicide.[9][10]

Onset of symptoms fi be triggered by events odas perceive as normal,[2] plus de disorder typically dey manifest insyd early adulthood den dey persist across diverse contexts.[11] BPD often be comorbid plus substance use disorders,[12][13] depressive disorders, den eating disorders.[2] Studies dey estimate up to 10 percent of people plus BPD die by suicide.[9][14] BPD dey face significant stigmatization insyd media portrayals den de psychiatric field, wey dey lead to underdiagnosis den insufficient treatment.[15][16]

Causes of BPD be unclear den complex, wey dey implicate genetic, neurological, den psychosocial conditions insyd ein development.[17][18] De current hypothesis dey suggest BPD be caused by an interaction between genetic factors den adverse childhood experiences.[19][20] BPD significantly be more common insyd people plus a family history of BPD, particularly immediate relatives, wey dey suggest genetic predisposition.[20] Der be a risk of misdiagnosis, wey BPD commonly be confused plus a mood disorder, substance use disorder, anaa oda mental health disorders.[11]

Therapeutic interventions predominantly dey involve psychotherapy, plus dialectical behavior therapy (DBT) den schema therapy be de most effective.[17][16] Although pharmacotherapy no dey cure BPD, e fi be employed to mitigate symptoms,[17] plus atypical antipsychotics den selective serotonin reuptake inhibitor (SSRI) antidepressants commonly prescribed. Dem dey use medications cautiously wey fi get minimal impact on neural function.[21][22][23] Despite de high utilization of healthcare resources by people plus BPD,[24] up to half fi show significant improvement over ten years plus appropriate treatment.[11]

Estimation of BPD ein prevalence dey vary. Insyd de US, around 1% of de population be diagnosed plus am.[25] BPD be more prevalent among adolescents den young adults dan elderly, wey symptoms fi remit plus age.[25] De term 'borderline' be debated, as e refer to concepts of borderline insanity den patients on de border between neurosis den psychosis, wich now be considered clinically imprecise.[17][26]

References

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  1. 1 2 American Psychiatric Association 2013, pp. 645, 663–6
  2. 1 2 3 4 5 "Borderline Personality Disorder". NIMH. Archived from the original on 22 March 2016. Retrieved 16 March 2016.
  3. ↑ Chapman AL (August 2019). "Borderline personality disorder and emotion dysregulation". Development and Psychopathology. 31 (3). Cambridge University Press: 1143–1156. doi:10.1017/S0954579419000658. PMID 31169118. S2CID 174813414. Archived from the original on 4 December 2020. Retrieved 5 April 2020.
  4. ↑ Bozzatello P, Rocca P, Baldassarri L, Bosia M, Bellino S (23 September 2021). "The Role of Trauma in Early Onset Borderline Personality Disorder: A Biopsychosocial Perspective". Frontiers in Psychiatry. 12: 721361. doi:10.3389/fpsyt.2021.721361. PMC 8495240. PMID 34630181.
  5. ↑ Cattane N, Rossi R, Lanfredi M, Cattaneo A (June 2017). "Borderline personality disorder and childhood trauma: exploring the affected biological systems and mechanisms". BMC Psychiatry. 17 (1): 221. doi:10.1186/s12888-017-1383-2. PMC 5472954. PMID 28619017.
  6. ↑ "Borderline Personality Disorder". The National Institute of Mental Health. December 2017. Archived from the original on 29 March 2023. Retrieved 25 February 2021. Other signs or symptoms may include: [...] Impulsive and often dangerous behaviors [...] Self-harming behavior [...]. Borderline personality disorder is also associated with a significantly higher rate of self-harm and suicidal behavior than the general public.
  7. ↑ Helle AC, Watts AL, Trull TJ, Sher KJ (2019). "Alcohol Use Disorder and Antisocial and Borderline Personality Disorders". Alcohol Research: Current Reviews. 40 (1): arcr.v40.1.05. doi:10.35946/arcr.v40.1.05. PMC 6927749. PMID 31886107.
  8. ↑ Trull, Timothy J.; Freeman, Lindsey K.; Vebares, Tayler J.; Choate, Alexandria M.; Helle, Ashley C.; Wycoff, Andrea M. (19 September 2018). "Borderline personality disorder and substance use disorders: an updated review". Borderline Personality Disorder and Emotion Dysregulation (in English). 5 (1): 15. doi:10.1186/s40479-018-0093-9. ISSN 2051-6673. PMC 6145127. PMID 30250740.
  9. 1 2 Kreisman J, Strauss H (2004). Sometimes I Act Crazy. Living With Borderline Personality Disorder. Wiley & Sons. p. 206. ISBN 978-0-471-22286-6.
  10. ↑ Kaurin, Aleksandra; Dombrovski, Alexandre; Hallquist, Michael; Wright, Aidan (2020-12-10). "Momentary Interpersonal Processes of Suicidal Surges in Borderline Personality Disorder". Psychological Medicine. 52 (13): 2702–2712. doi:10.1017/S0033291720004791. PMC 8190164. PMID 33298227. People diagnosed with borderline personality disorder (BPD) are at high risk of dying by suicide: almost all report chronic suicidal ideation, 84% of patients with BPD engage in suicidal behavior, 70% attempt suicide, with a mean of 3.4 lifetime attempts per individual, and 5–10% die by suicide (Black et al., 2004; McGirr et al., 2007; Soloff et al., 1994).
  11. 1 2 3 American Psychiatric Association, 2013
  12. ↑ Helle AC, Watts AL, Trull TJ, Sher KJ (2019). "Alcohol Use Disorder and Antisocial and Borderline Personality Disorders". Alcohol Research: Current Reviews. 40 (1) arcr.v40.1.05. doi:10.35946/arcr.v40.1.05. PMC 6927749. PMID 31886107.
  13. ↑ Trull, Timothy J.; Freeman, Lindsey K.; Vebares, Tayler J.; Choate, Alexandria M.; Helle, Ashley C.; Wycoff, Andrea M. (December 2018). "Borderline personality disorder and substance use disorders: an updated review". Borderline Personality Disorder and Emotion Dysregulation. 5 (1). doi:10.1186/s40479-018-0093-9. PMC 6145127. PMID 30250740.
  14. ↑ Kaurin, Aleksandra; Dombrovski, Alexandre; Hallquist, Michael; Wright, Aidan (2020-12-10). "Momentary Interpersonal Processes of Suicidal Surges in Borderline Personality Disorder". Psychological Medicine. 52 (13): 2702–2712. doi:10.1017/S0033291720004791. PMC 8190164. PMID 33298227. People diagnosed with borderline personality disorder (BPD) are at high risk of dying by suicide: almost all report chronic suicidal ideation, 84% of patients with BPD engage in suicidal behavior, 70% attempt suicide, with a mean of 3.4 lifetime attempts per individual, and 5–10% die by suicide (Black et al., 2004; McGirr et al., 2007; Soloff et al., 1994).
  15. ↑ Aviram, Ron B.; Brodsky, Beth S.; Stanley, Barbara (September 2006). "Borderline Personality Disorder, Stigma, and Treatment Implications". Harvard Review of Psychiatry. 14 (5): 249–256. doi:10.1080/10673220600975121. PMID 16990170. The stigmatization of BPD is likely to be a result of several characteristics of the BPD syndrome. [... Pejorative] terms such as "difficult," "treatment resistant," "manipulative," "demanding," and "attention seeking" [are used to describe such individuals. This] can have an impact upon the treater's a priori expectations. [... Such] stigmatization is likely to be a result of several [behaviour characteristics of individuals with BPD, and the fact that] psychotherapy with [them] may involve disturbing and frightening behavior, including intense anger, chronic suicidal ideation, self-injury, and suicide attempts. [... Clinicians, under the stigma, may] see lower levels of [their patient's] functioning as deliberate and within [ones] control, or as manipulation, or as a rejection of help, [and may therefore respond] in unintentially damaging ways, [possibly by withdrawing] physically and emotionally. [...] It has been found that when one person has negative expectations of another, the former changes his or her behavior toward the latter. These interpersonal situations have been described as self-fulfilling prophecies.
  16. 1 2 Dixon-Gordon KL, Peters JR, Fertuck EA, Yen S (2017). "Emotional Processes in Borderline Personality Disorder: An Update for Clinical Practice". Journal of Psychotherapy Integration. 27 (4): 425–438. doi:10.1037/int0000044. PMC 5842953. PMID 29527105. [Clinicians] may hesitate to [provide treatment for BPD patients] due to discomfort working with the high-risk behaviours and intense interpersonal and emotional dysregulation typical of [the disorder. Treatments supported by empirical evidence include Dialectical behavior therapy, Mentalization-based treatment, Transference-focused psychotherapy, Schema-focused therapy, and General Psychiatric Management... On the psychopathology side, it's possible that] emotional reactivity may be [more] pronounced [...] in response to social stressors and in interpersonal and self-conscious emotions (e.g., anger, shame) [...] Emotional vulnerability in BPD may also vary across specific emotions, [to which] sadness, hostility, and fear [are particularly damaging].
  17. 1 2 3 4 "Borderline Personality Disorder". NIMH. Archived from the original on 22 March 2016. Retrieved 16 March 2016.
  18. ↑ "Causes - Borderline personality disorder". nhs.uk (in English). 2021-02-12. Retrieved 2025-12-21.
  19. ↑ Chapman, Jennifer; Jamil, Radia T.; Fleisher, Carl; Torrico, Tyler J. (2025), "Borderline Personality Disorder", StatPearls, Treasure Island, Fla.: StatPearls Publishing, PMID 28613633, retrieved 2025-06-10, The current hypothesis is that BPD is caused by an interaction between genetic factors and adverse childhood experiences affecting brain development via neuropeptides and hormones. The relative importance of these factors is unclear.
  20. 1 2 Leichsenring, Falk; Fonagy, Peter; Heim, Nikolas; Kernberg, Otto F.; Leweke, Frank; Luyten, Patrick; Salzer, Simone; Spitzer, Carsten; Steinert, Christiane (February 2024). "Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies". World Psychiatry. 23 (1): 4–25. doi:10.1002/wps.21156. PMC 10786009. PMID 38214629. It is currently hypothesized that, in BPD, genetic factors and adverse childhood experiences interact to influence brain development via hormones and neuropeptides. Adverse childhood experiences are thought to modulate gene expression and lead to stable personality traits that may predispose to BPD. [...] There is familial aggregation of BPD, with recent data from a Swedish population-based study estimating heritability at 46%. The risk of receiving a BPD diagnosis was increased 4.7-fold for full siblings. The hazard ratio in identical twins was 11.5.
  21. ↑ Cattarinussi G, Delvecchio G, Prunas C, Moltrasio C, Brambilla P (June 2021). "Effects of pharmacological treatments on emotional tasks in borderline personality disorder: A review of functional magnetic resonance imaging studies". Journal of Affective Disorders. 288: 50–57. doi:10.1016/j.jad.2021.03.088. PMID 33839558.
  22. ↑ Pascual JC, Arias L, Soler J (31 May 2023). "Pharmacological Management of Borderline Personality Disorder and Common Comorbidities". CNS Drugs. 37 (6): 489–497. doi:10.1007/s40263-023-01015-6. PMC 10276775. PMID 37256484. Comorbidity with other mental disorders is common in individuals with BPD [... Despite no drug has been approved specifically for the treatment of BPD,] various medications are routinely prescribed off label [, but] agreement among clinical guidelines [is lacking]. Comorbidity [of] other psychiatric disorders is considered [the] main [reason for the effectiveness of] pharmacological treatment and polypharmacy[. Patients receiving] BPD-specific psychotherapy usually require fewer medications[.]
  23. ↑ Gerolymos, Cyril; Garosi, Alexandra; Boyer, Laurent; Yon, Dong Keon; Rahmati, Masoud; Gavaudan, Mika; Fond, Guillaume (2026-02-10). "Efficacy and safety of pharmacological treatments in borderline personality disorder: A systematic review and network meta-analysis". Molecular Psychiatry (in English): 1–13. doi:10.1038/s41380-026-03451-4. ISSN 1476-5578.
  24. ↑ Bourke J, Murphy A, Flynn D, Kells M, Joyce M, Hurley J (September 2021). "Borderline personality disorder: resource utilisation costs in Ireland". Irish Journal of Psychological Medicine. 38 (3): 169–176. doi:10.1017/ipm.2018.30. hdl:10468/7005. PMID 34465404.
  25. 1 2 Ellison, William D.; Rosenstein, Lia K.; Morgan, Theresa A.; Zimmerman, Mark (December 2018). "Community and Clinical Epidemiology of Borderline Personality Disorder". Psychiatric Clinics of North America. 41 (4): 561–573. doi:10.1016/j.psc.2018.07.008. PMID 30447724. BPD tends to be more prevalent in adult women than adult men, [but] this gender split is not apparent among adolescents. [...] BPD has been found to decrease and even remit as individuals age. [...] BPD [has] a point prevalence around 1%. [Prevalence differ between subpopulations, being] substantially higher [for psychiatric population, around 12% for outpatient and 22% for inpatient.] Research also suggests [potential] differences [between] ethnic groups[. Deliberate] self-harm [...] differs among ethnic groups, [with] African-American individuals [reporting] more affective instability and emotion dysregulation, but less suicidal behavior and deliberate self-harm, than White American individuals with the disorder.
  26. ↑ Gunderson JG (May 2009). "Borderline personality disorder: ontogeny of a diagnosis". The American Journal of Psychiatry. 166 (5): 530–539. doi:10.1176/appi.ajp.2009.08121825. PMC 3145201. PMID 19411380.

General bibliography

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