The Diagnosis and Treatment of Borderline Personality Disorder

Joel Paris, MD

Chair, Department of Psychiatry
McGill University
Montreal, Quebec

Borderline personality disorder, which is present in approximately 1% of the population, usually begins in adolescence and affects people over the course of many years. Its severe clinical picture is characterized by extreme mood instability, impulsive actions, and unstable interpersonal relationships.^1,2 Because of the pronounced fluctuations in mood, it is often initially confused with bipolar disorder. Unlike bipolar disorder, however, there are no manic or hypomanic episodes lasting days, and treatment with mood stabilizers yields little response.³ Instead, the mood of patients with borderline personality can shift radically from hour to hour. These patients’ uncontrollable impulsivity frequently results in substance abuse, overdose, self-injury, and suicidality. They become attached to others very quickly and react disproportionately when relationships don’t work out.⁴ Patients with borderline personality tend to function much better in highly structured environments, such as work and school. Here, Dr. Paris discusses the biopsychosocial etiology of borderline personality disorder, as well as its diagnostic criteria and the most effective treatment options.

References

Paris J. The nature of borderline personality disorder: multiple dimensions, multiple symptoms, but one category. J Pers Disord. 2007;21:457-473.
Russell JJ, Moskowitz DS, Zuroff DC, Sookman D, Paris J. Stability and variability of affective experience and interpersonal behavior in borderline personality disorder. J Abnorm Psychol. 2007;116:578-588.
Paris J, Gunderson J, Weinberg I. The interface between borderline personality disorder and bipolar spectrum disorders. Compr Psychiatry. 2007;48:145-154.
Sadikaj G, Russell JJ, Moskowitz DS, Paris J. Affect dysregulation in individuals with borderline personality disorder: persistence and interpersonal triggers. J Pers Assess. 2010;92:490-500.

Would you like to comment? , or in if you are already a member.

Annual Research Review: Hoarding disorder: potential benefits and pitfalls of a new mental disorder

Mataix-Cols D, Pertusa A.
Departments of Psychosis Studies and Psychology, King's College...

Depression in Youth with obsessive-compulsive disorder: Clinical phenomenology and correlates

Storch EA, Lewin AB, Larson MJ, Geffken GR, Murphy TK, Geller DA.

Source
Department of...

Thought Control Strategies in Adolescents: Links with OCD Symptoms and Meta-Cognitive Beliefs

Wilson C, Hall M.
Trinity College Dublin, Ireland.

Abstract
Background: The...

Stressful life events and obsessive-compulsive disorder: clinical features and symptom dimensions

Rosso G, Albert U, Asinari GF, Bogetto F, Maina G.

Abstract
The potential role of...

Intolerance of uncertainty, hypochondriacal concerns, obsessive-compulsive symptoms, and worry.

Boelen PA, Carleton RN.
*Department of Clinical and Health Psychology, Utrecht University,...