A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience
Issue link: https://innovationscns.epubxp.com/i/555782
[ V O L U M E 1 2 , N U M B E R 7 – 8 , J U L Y – A U G U S T 2 0 1 5 ] Innovations in CLINICAL NEUROSCIENCE 39 T H E I N T E R F A C E ABSTRACT Borderline personality disorder is a personality dysfunction that is characterized by disinhibition and impulsivity, which oftentimes manifest as self-regulation difficulties. Patients with this disorder have always been present in medical settings, but have been described as "difficult patients" rather than patients with borderline personality disorder. According to empirical findings, a number of behaviors and medical syndromes/diagnoses are suggestive of borderline personality disorder. Suggestive behaviors in the medical setting may include aggressive or disruptive behaviors, the intentional sabotage of medical care, and excessive healthcare utilization. Suggestive medical syndromes and diagnoses in the medical setting may include alcohol and substance misuse (including the abuse of prescription medications), multiple somatic complaints, chronic pain, obesity, sexual impulsivity, and hair pulling. While not all-inclusive or diagnostic, these behaviors and syndromes/diagnoses may invite further clinical evaluation of the patient for borderline personality disorder. KEY WORDS Borderline personality, borderline personality disorder, healthcare, healthcare utilization, somatic, somatic preoccupation INTRODUCTION Borderline personality disorder (BPD) is a challenging personality dysfunction that is characterized by chronic disinhibition and impulsivity, which oftentimes culminates in self- regulation difficulties. In addition, these patients frequently display chronic self-destructive behavior. While well known in psychiatric settings, recognition of this disorder and its possible manifestations in the medical setting is continuing to unfold. As in psychiatric settings, BPD may be heralded by numerous suspicious behaviors and syndromes/diagnoses in the medical setting, although none of these are, by themselves, diagnostic. In this edition of The Interface, we discuss the accumulating empirical evidence related to the clinical manifestations of BPD in the medical setting, much of which includes our own investigations in this area. THE PREVALENCE OF BPD IN MEDICAL SETTINGS The prevalence of personality disorders in medical settings is under-researched, but individuals with personality dysfunction appear This ongoing column is dedicated to the challenging clinical interface between psychiatry and primary care—two fields that are inexorably linked. BORDERLINE PERSONALITY DISORDER IN THE MEDICAL SETTING: Suggestive Behaviors, Syndromes, and Diagnoses by Randy A. Sansone, MD, and Lori A. Sansone, MD Innov Clin Neurosci. 2015;12(7–8):39–44 The Interface