Borderline personality disorder (BPD) is a pattern of abnormal behavior characterized by extreme fear of abandonment; unstable relationships with other people, sense of self, or emotions; feelings of emptiness; frequent dangerous behavior; and self-harm. Symptoms may be triggered by seemingly normal events. This pattern of behavior typically begins by early adulthood, and occurs across a variety of situations. People with BPD often engage in idealization and devaluation of others, alternating between high positive regard and great disappointment. Substance abuse, depression, and eating disorders commonly co-exist with borderline personality disorder. About 6% die by suicide.
The cause of BPD is unclear but is believed to involve both genetic and environmental factors. Studies done on twins suggest that the illness is partly inherited from one's parents. Traits such as impulsiveness and aggression can be attributed to temperament. There is evidence that abnormalities of the fronto limbic networks are associated with many of the symptoms. The disorder is recognized in the Diagnostic and Statistical Manual of Mental Disorders. Since a personality disorder is a pervasive, enduring, and inflexible pattern of maladaptive inner experiences and pathological behavior, there is a general reluctance to diagnose personality disorders before adolescence or early adulthood. Diagnosis is based on the symptoms while a medical exam may be done to rule out other problems.
Borderline personality disorder is typically treated with counseling such as cognitive behavioral therapy. Another type, dialectical behavior therapy has been found to reduce the risk of suicide. Therapy may occur one-on-one or as a group. While medications do not cure BPD they may be used for the associated symptoms. About 1.6% of people have BPD in a given year. Some require care in hospital. There is an ongoing debate about the naming of the disorder, especially the suitability of the word "borderline". The ICD-10 manual refers to the disorder as emotionally unstable personality disorder and has similar diagnostic criteria. In theDSM-5, the name of the disorder remains the same as in the previous editions.
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http://archpsyc.jamanetwork.com/article.aspx?articleid=1107231 ten-year course of borderline personality disorderpsychopathology and function from the collaborative longitudinal personality disorders study by john g. Gunderson, md et al., arch gen psychiatry. 2011;68(8):827-837. Doi:10.1001/archgenpsychiatry.2011.37.
http://bjp.rcpsych.org/content/196/1/4 review article:pharmacotherapy for borderline personality disorder: cochrane systematic review of randomised trials by klaus lieb, birgit völlm, gerta rücker, antje timmer, jutta m. Stoffers the british journal of psychiatry dec 2009, 196 (1) 4-12; doi: 10.1192/bjp.bp.108.062984