A 22yo woman was brought by her boyfriend with multiple superficial lacerations. There are
scars of old cuts on her forearms. She is distressed because he wants to end the relationship.
She denies suicide. What is the most likely dx?
a. Acute psychosis
b. Borderline personality disorder
c. Severe depression
d. Schizoid personality
e. Psychotic depression
answer: B
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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