2
Key Points
Key Points
➤ The lifetime prevalence of borderline personality disorder (BPD) in the United
States is approximately 1.4%-2.7%, although estimates can vary. Symptom
onset may extend back to early adolescence although the diagnosis of BPD
may not be made until later in adolescence or adulthood.
➤ Specific symptoms include a long-term pattern of instability of interpersonal
relationships, unstable self-image, marked impulsivity and/or affective
instability, fear of abandonment, feelings of emptiness, intense anger, an
unstable self-image, suicide attempts and transient paranoid ideation or
stress-related dissociative symptoms.
➤ Individuals with BPD commonly suffer from other psychiatric disorders such
as major depressive disorder (MDD), bipolar disorder, posttraumatic stress
disorder (PTSD), anxiety disorders, eating disorders, attention-deficit/
hyperactivity disorder (ADHD), and substance use disorders (SUDs).
➤ This condition can remit, and BPD symptoms can be reduced and managed
with a comprehensive, person-centered treatment plan that includes
structured psychotherapy and adjunct pharmacotherapy for targeted
symptoms.
Assessment and Determination of Treatment Plan
Statement 1 - Initial Assessment
➤ APA recommends (1C) that the initial assessment of a patient with possible
BPD include the reason the individual is presenting for evaluation; the
patient's goals and preferences for treatment; a review of psychiatric
symptoms, including core features of personality disorders and common co-
occurring disorders; a psychiatric treatment history; an assessment of physical
health; an assessment of psychosocial and cultural factors; a mental status
examination; and an assessment of risk of suicide, self-injury, and aggressive
behaviors, as outlined in APA's Practice Guidelines for the Psychiatric
Evaluation of Adults, 3rd Edition.
Statement 2 - Quantitative Measures
➤ APA suggests (2C) that the initial psychiatric evaluation of a patient with
possible BPD include a quantitative measure to identify and determine the
severity of symptoms and impairments of functioning that may be a focus of
treatment.
Assessment