Emotionally Unstable (Borderline) Personality Disorder is a condition characterized by impulsive actions, rapidly shifting moods, and chaotic relationships. The individual usually goes from one emotional crisis to another. Often there is dependency, separation anxiety, unstable self-image, chronic feelings of emptiness, and threats of self-harm (suicide or self-mutilation). This disorder is only diagnosed when these behaviors become persistent and very disabling/distressing.
Complications:
Completed suicide occurs in 8%-10% of individuals with this disorder, and self-mutilative acts (e.g., cutting or burning) and suicide threats and attempts are very common. Recurrent job losses, interrupted education, and broken marriages are common.
Comorbidity:
Very stressful or chaotic childhoods are commonly reported (e.g., physical and sexual abuse, neglect, hostile conflict, and early parental loss or separation). Mood disorders, Substance-Related Disorders, Eating Disorders (usually Bulimia), Posttraumatic Stress Disorder, Attention-Deficit/Hyperactivity Disorder, and other Personality Disorders frequently co-occur with this disorder.
Associated Laboratory Findings:
No laboratory test has been found to be diagnostic of this disorder.
Prevalence:
The prevalence of Emotionally Unstable (Borderline) Personality Disorder is about 2% of the general population. It is seen in 10% of psychiatric outpatients, and 20% of psychiatric inpatients. This disorder is more frequent in females (about 75%) than males. Emotional instability and impulsivity are very common in adolescents, but most adolescents grow out of this behavior. Unfortunately, for some, this emotional instability and impulsivity persists and intensifies into adulthood; thus they become diagnosed with this disorder.
Course:
The course of this disorder is quite variable. The most common pattern is one of chronic instability in early adulthood. This disorder is usually worse in the young-adult years and it gradually decreases with age. During their 30s and 40s, the majority of individuals with this disorder attain greater stability in their relationships and vocational functioning. After about 10 years, about half of individuals with this disorder no longer meet the full criteria for Borderline Personality Disorder.
Familial Pattern:
This disorder is about 5 times more common among first-degree biological relatives of those with the disorder than in the general population. There is also an increased familial risk for Substance-Related Disorders, Antisocial Personality Disorder, and Mood Disorders.
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