Emotionally unstable personality disorder – impulsive or borderline type[1]
Emotional intensity disorder[2]
Hysteria[3]
Hysteric personality – Hysteroid[4]
Negative affectivity/neuroticism[5]
Despair by Edvard Munch (1894), who is presumed to have had borderline personality disorder[6][7]
Specialty
Psychiatry, clinical psychology
Symptoms
Unstable relationships, distorted sense of self, and intense emotions; impulsivity; recurrent suicidal and self-harming behavior; fear of abandonment; chronic feelings of emptiness; inappropriate anger; dissociation[8][9]
Complications
Suicide, self harm[8]
Usual onset
Early adulthood[9]
Duration
Long term[8]
Causes
Genetic, neurobiologic, psychosocial[10]
Risk factors
Family history, childhood trauma[10]
Diagnostic method
Based on reported symptoms[8]
Differential diagnosis
See § Differential diagnosis
Treatment
Behaviour therapy[8]
Prognosis
Improves over time,[9] remission occurs in 45% of patients over a wide range of follow-up periods[11][12][13][14][15]
Frequency
5.9% (lifetime prevalence)[8]
Personality disorders
Cluster A (odd)
Paranoid
Schizoid
Schizotypal
Cluster B (dramatic)
Antisocial
Borderline
Histrionic
Narcissistic
Cluster C (anxious)
Avoidant
Dependent
Obsessive–compulsive
Not otherwise specified
Depressive
Depressive
Cyclothymic
Others
Passive–aggressive
Masochistic
Sadistic
Psychopathy
Haltlose
Immature
Post-traumatic organic
v
t
e
Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD),[16] is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, a distorted sense of self, and intense emotional responses.[9][17][18] Individuals diagnosed with BPD frequently exhibit self-harming behaviours and engage in risky activities, primarily due to challenges in regulating emotional states to a healthy, stable baseline.[19][20][21] Symptoms such as dissociation (a feeling of detachment from reality), a pervasive sense of emptiness, and an acute fear of abandonment are prevalent among those affected.[17]
The onset of BPD symptoms can be triggered by events that others might perceive as normal,[17] with the disorder typically manifesting in early adulthood and persisting across diverse contexts.[9] BPD is often comorbid with substance use disorders,[22] depressive disorders, and eating disorders.[17] BPD is associated with a substantial risk of suicide;[9][17] an estimated at 8 to 10 percent of individuals with BPD die by suicide, with males affected at twice the rate of females.[23] Despite its severity, BPD faces significant stigmatization in both media portrayals and within the psychiatric field, potentially leading to its underdiagnosis.[24]
The causes of BPD are unclear and complex, implicating genetic, neurological, and psychosocial conditions in its development.[8][25] A genetic predisposition is evident, with the disorder being significantly more common in individuals with a family history of BPD, particularly immediate relatives.[8] Psychosocial factors, particularly adverse life events like adverse childhood experiences, also play a role.[26] Neurologically, the underlying mechanism appears to involve the frontolimbic neuronal network of the limbic system.[26] The American Diagnostic and Statistical Manual of Mental Disorders (DSM) classifies BPD as a cluster B personality disorder, alongside antisocial, histrionic, and narcissistic personality disorders.[9] There exists a small risk of misdiagnosis, with BPD most commonly confused with a mood disorder, substance use disorder, or other mental health disorders.[9]
Therapeutic interventions for BPD predominantly involve psychotherapy, with cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT) being the most effective modalities.[8] This psychotherapy can occur one-on-one or in a group.[8] Although pharmacotherapy cannot cure BPD, it may be employed to mitigate associated symptoms,[8] with quetiapine and selective serotonin reuptake inhibitor (SSRI) antidepressants being commonly prescribed even though their efficacy is unclear. A 2002 study found fluvoxamine (an SSRI) significantly decreased rapid mood shifts in females with BPD,[27] while a more recent meta-analysis found the use of medications was still unsupported by evidence.[28] In severe cases, hospitalization may be necessitated, even if for only short periods.[8]
BPD has a point prevalence of 1.6% and a lifetime prevalence of 5.9% of the global population,[9][8][29][30] with a higher incidence rate among women compared to men in the clinical setting of up to three times.[9][29] Two epidemiological studies conducted on the general population in the United States have shown that the lifetime prevalence of BPD shows no significant difference between males and females.[31][32] Despite the high utilization of healthcare resources by individuals with BPD,[33] up to half may show significant improvement over a ten-year period with appropriate treatment.[9] The naming of the disorder, particularly the suitability of the term borderline, is a subject of ongoing debate. Initially, the term reflected historical notions referring to borderline insanity and later described patients on the border between neurosis and psychosis. These interpretations are now regarded as outdated and clinically imprecise.[8][34]
^Cloninger RC (2005). "Antisocial Personality Disorder: A Review". In Maj M, Akiskal HS, Mezzich JE (eds.). Personality disorders. New York City: John Wiley & Sons. p. 126. ISBN 978-0-470-09036-7. Archived from the original on 4 December 2020. Retrieved 5 June 2020.
^Blom JD (2010). A Dictionary of Hallucinations (1st ed.). New York: Springer. p. 74. ISBN 978-1-4419-1223-7. Archived from the original on 4 December 2020. Retrieved 5 June 2020.
^Bollas C, et al. (American Psychological Association) (2000). Hysteria (1st ed.). Taylor & Francis. Archived from the original on 15 December 2022. Retrieved 14 December 2022.
^Novais F, Araújo A, Godinho P (25 September 2015). "Historical roots of histrionic personality disorder". Frontiers in Psychology. 6 (1463): 1463. doi:10.3389/fpsyg.2015.01463. PMC 4585318. PMID 26441812.
^"ICD-11 - ICD-11 for Mortality and Morbidity Statistics". World Health Organization. Archived from the original on 1 August 2018. Retrieved 6 October 2021.
^Aarkrog T (1990). Edvard Munch: The Life of a Person with Borderline Personality as Seen Through His Art [Edvard Munch, et livsløb af en grænsepersonlighed forstået gennem hans billeder]. Danmark: Lundbeck Pharma A/S. ISBN 978-87-983524-1-9.
^Wylie HW (1980). "Edvard Munch". The American Imago; A Psychoanalytic Journal for the Arts and Sciences. 37 (4). Johns Hopkins University Press: 413–443. JSTOR 26303797. PMID 7008567. Archived from the original on 10 August 2021. Retrieved 10 August 2021.
^ abcdefghijklmn"Borderline Personality Disorder". NIMH. Archived from the original on 22 March 2016. Retrieved 16 March 2016.
^ abcdefghijkAmerican Psychiatric Association 2013, pp. 645, 663–6
^ abCaspi A, McClay J, Moffitt TE, Mill J, Martin J, Craig IW, et al. (2 August 2002). "Role of Genotype in the Cycle of Violence in Maltreated Children". Science. 297 (5582): 851–854. Bibcode:2002Sci...297..851C. doi:10.1126/science.1072290. ISSN 0036-8075. PMID 12161658.
^Skodol AE, Siever LJ, Livesley W, Gunderson JG, Pfohl B, Widiger TA (2002). "The borderline diagnosis II: biology, genetics, and clinical course". Biological Psychiatry. 51 (12): 951–963. doi:10.1016/S0006-3223(02)01325-2. PMID 12062878.
^Skodol AE, Bender DS, Pagano ME, Shea MT, Yen S, Sanislow CA, et al. (15 July 2007). "Positive Childhood Experiences: Resilience and Recovery From Personality Disorder in Early Adulthood". The Journal of Clinical Psychiatry. 68 (7): 1102–1108. doi:10.4088/JCP.v68n0719. ISSN 0160-6689. PMC 2705622. PMID 17685749.
^Zanarini MC, Frankenburg FR, Hennen J, Reich DB, Silk KR (2006). "Prediction of the 10-Year Course of Borderline Personality Disorder". American Journal of Psychiatry. 163 (5): 827–832. doi:10.1176/ajp.2006.163.5.827. ISSN 0002-953X. PMID 16648323.
^Zanarini MC, Frankenburg FR, Reich DB, Fitzmaurice G (2010). "Time to Attainment of Recovery From Borderline Personality Disorder and Stability of Recovery: A 10-year Prospective Follow-Up Study". American Journal of Psychiatry. 167 (6): 663–667. doi:10.1176/appi.ajp.2009.09081130. ISSN 0002-953X. PMC 3203735. PMID 20395399.
^Zanarini MC, Frankenburg FR, Reich DB, Fitzmaurice G (2012). "Attainment and Stability of Sustained Symptomatic Remission and Recovery Among Patients With Borderline Personality Disorder and Axis II Comparison Subjects: A 16-Year Prospective Follow-Up Study". American Journal of Psychiatry. 169 (5): 476–483. doi:10.1176/appi.ajp.2011.11101550. ISSN 0002-953X. PMC 3509999. PMID 22737693.
^Borderline personality disorder NICE Clinical Guidelines, No. 78. British Psychological Society. 2009. Archived from the original on 12 November 2020. Retrieved 11 September 2017.
^ abcde"Borderline Personality Disorder". NIMH. Archived from the original on 22 March 2016. Retrieved 16 March 2016.
^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.
^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.
^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.
^"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.
^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.
^Kreisman J, Strauss H (2004). Sometimes I Act Crazy. Living With Borderline Personality Disorder. Wiley & Sons. p. 206. ISBN 978-0-471-22286-6.
^Aviram RB, Brodsky BS, Stanley B (2006). "Borderline personality disorder, stigma, and treatment implications". Harvard Review of Psychiatry. 14 (5): 249–256. doi:10.1080/10673220600975121. PMID 16990170. S2CID 23923078.
^Clinical Practice Guideline for the Management of Borderline Personality Disorder. Melbourne: National Health and Medical Research Council. 2013. pp. 40–41. ISBN 978-1-86496-564-3. In addition to the evidence identified by the systematic review, the Committee also considered a recent narrative review of studies that have evaluated biological and environmental factors as potential risk factors for BPD (including prospective studies of children and adolescents, and studies of young people with BPD)
^ abLeichsenring F, Leibing E, Kruse J, New AS, Leweke F (January 2011). "Borderline personality disorder". Lancet. 377 (9759): 74–84. doi:10.1016/s0140-6736(10)61422-5. PMID 21195251. S2CID 17051114.
^Rinne T, van den Brink W, Wouters L, van Dyck R (December 2002). "SSRI treatment of borderline personality disorder: a randomized, placebo-controlled clinical trial for female patients with borderline personality disorder". The American Journal of Psychiatry. 159 (12): 2048–2054. CiteSeerX 10.1.1.621.525. doi:10.1176/appi.ajp.159.12.2048. PMID 12450955.
^Cite error: The named reference stofferswinterling20 was invoked but never defined (see the help page).
^ ab"Borderline personality disorder: Epidemiology, pathogenesis, clinical features, course, assessment, and diagnosis". UpToDate. Wolters Kluwer. Archived from the original on 6 January 2009. Retrieved 13 March 2024.
^"NIMH " Personality Disorders". nimh.nih.gov. Archived from the original on 18 June 2022. Retrieved 20 May 2021.
^Lenzenweger MF, Lane MC, Loranger AW, Kessler RC (September 2007). "DSM-IV personality disorders in the National Comorbidity Survey Replication". Biological Psychiatry. 62 (6): 553–564. doi:10.1016/j.biopsych.2006.09.019. PMC 2044500. PMID 17217923.
^Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, et al. (April 2008). "Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions". The Journal of Clinical Psychiatry. 69 (4): 533–545. doi:10.4088/JCP.v69n0404. PMC 2676679. PMID 18426259.
^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.
^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.
and 22 Related for: Borderline personality disorder information
Borderlinepersonalitydisorder (BPD), also known as emotionally unstable personalitydisorder (EUPD), is a personalitydisorder characterized by a pervasive...
therapy especially for borderlinepersonalitydisorder. A variety of psychoanalytic approaches are also used. Personalitydisorders are associated with considerable...
The mainstay of management of borderlinepersonalitydisorder is various forms of psychotherapy with medications being found to be of little use. There...
Narcissistic personalitydisorder (NPD) is a personalitydisorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive...
Dissociative identity disorder (DID), also known as multiple personalitydisorder, split personalitydisorder, or dissociative personalitydisorder, is a member...
Schizotypal personalitydisorder (StPD or SPD), also known as schizotypal disorder, is a cluster A personalitydisorder. The Diagnostic and Statistical...
Borderlinepersonalitydisorder (BPD) is a personalitydisorder characterized by a pervasive, long-term pattern of significant interpersonal relationship...
Schizoid personalitydisorder (/ˈskɪtsɔɪd, ˈskɪdzɔɪd, ˈskɪzɔɪd/, often abbreviated as SzPD or ScPD) is a personalitydisorder characterized by a lack of...
as cyclothymic disorder, psychothemia / psychothymia, bipolar III, affective personalitydisorder and cyclothymic personalitydisorder, is a mental and...
narcissistic, avoidant, and borderline. A genetic contribution to paranoid traits and a possible genetic link between this personalitydisorder and schizophrenia...
psychological pain remains disputed. Borderlinepersonalitydisorder (BPD) has long been believed to be a disorder that produces the most intense emotional...
public her own struggles and belief that she suffers from borderlinepersonalitydisorder. DBT grew out of a series of failed attempts to apply the standard...
Antisocial personalitydisorder (ASPD or APD) is a personalitydisorder characterized by a limited capacity for empathy and a long-term pattern of disregard...
The McLean Screening Instrument for BorderlinePersonalityDisorder (MSI-BPD) is a 10-question self-report screening tool used to identify individuals...
the underlying psychiatric disorder: a mood disorder, an anxiety disorder, or borderlinepersonalitydisorder. The patient's prognosis depends upon the...
Haltlose personalitydisorder was a type of personalitydisorder diagnosis largely used in German-, Russian- and French-speaking countries. The German...
Kernberg's object relations model of borderlinepersonalitydisorder (BPD). It views the individual with borderlinepersonality organization (BPO) as holding...
Histrionic personalitydisorder (HPD) is defined by the American Psychiatric Association as a personalitydisorder characterized by a pattern of excessive...
The Zanarini Rating Scale for BorderlinePersonalityDisorder (ZAN-BPD) is a standardized, diagnostic rating scale designed to measure the severity and...
diagnosable personalitydisorders. Borderlinepersonalitydisorder – there is a tendency for loved ones of people with borderlinepersonalitydisorder (BPD)...