Although pharmacotherapy cannot cure BPD, it may be employed to mitigate associated symptoms, with quetiapine and selective serotonin reuptake inhibitor (SSRI) antidepressants being commonly prescribed even though their efficacy is unclear. This psychotherapy can occur one-on-one or in a group. Therapeutic interventions for BPD predominantly involve psychotherapy, with cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT) being the most effective modalities. There exists a small risk of misdiagnosis, with BPD most commonly confused with a mood disorder, substance use disorder, or other mental health disorder. 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. Neurologically, the underlying mechanism appears to involve the frontolimbic neuronal network of the limbic system. Psychosocial factors, particularly adverse life events like adverse childhood experiences, also play a role. A genetic predisposition is evident, with the disorder being significantly more common in individuals with a family history of BPD, particularly immediate relatives. The causes of BPD are unclear and complex, implicating genetic, neurological, and psychosocial conditions in its development. Despite its severity, BPD faces significant stigmatization in both media portrayals and within the psychiatric field, potentially leading to its underdiagnosis. BPD is associated with a substantial risk of suicide an estimated at 8 to 10 percent of individuals with BPD die by suicide, with males affected at twice the rate of females. BPD is often comorbid with substance use disorders, depressive disorders, and eating disorders. The onset of BPD symptoms can be triggered by events that others might perceive as normal, with the disorder typically manifesting in early adulthood and persisting across diverse contexts. 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. 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. Improves over time, remission occurs in 45% of patients over a wide range of follow-up periods īorderline personality disorder ( BPD), also known as emotionally unstable personality disorder ( EUPD), 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. 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
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