A 25 yo woman was brought to the ED by her boyfriend. She has many superficial lacerations on
her forearm. She is so distressed and constantly says her boyfriend is going to end the
relationship. She denies trying to end her life. What is the most likely dx?
a. Acute psychosis
b. Severe depression
c. Psychotic depression
d. Borderline personality disorder
e. Schizophrenia
answer: D
Borderline Personality Disorder (2-4%)
Unstable moods and behavior, feel alone in the world, problems with self image. History of repeated suicide attempts, self-harm behaviors.
**10% suicide rate**
Diagnosis requires 5 of:
1. Frantic efforts to avoid real or imagined abandonment
2. Unstable and intense relationships
3. Unstable sense of self
4. Impulsivity in two potentially harmful ways (sexual, drugs,spending)
5. Recurrent suicidal behavior/self-harm
6. Unstable mood/affect
7. General feelings of emptiness
8. Difficulty controlling anger
9. Transient dissociative symptoms or paranoid ideation associated with stress
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