A young female who has many superficial lacerations was brought into the ED by her boyfriend
for superficially lashing her upper arm. She is adamant and screaming that she is not suicidal but
scared her boyfriend wants to leave her. What is the dx?
a. Acute psychosis
b. Severe depression
c. Obsessive
d. Bipolar
e. Borderline personality
f. Schizophrenia
answer: E
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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