Gunderson and Singer reviewed the literature and listed several features that identify borderline personality disorder, and a diagnostic interview based on these features was later developed by Gunderson and colleagues. The term was later expanded in the late 1960s and 1970s by Otto Kernberg this diagnosis was used in empirical studies conducted by Grinker and Werble. He used it to refer to a group of patients whose conditions worsened during therapy and who showed masochistic behaviour and psychic rigidity, indicating a protective mechanism against any perceived changes in the environment or within the individual. What is the origin of the term “borderline personality disorder”?The term “borderline” was first described by the psychoanalyst Adolf Stern in 1938. When necessary, specific diagnostic criteria, such as emptiness and affective instability, were used as search terms to provide further detail regarding the differential diagnosis. The most recent articles were preferred for inclusion, particularly those that reflected the current diagnostic criteria and were applicable across multiple clinical settings. We retrieved the full-text versions if they were relevant to general clinical practice. After reviewing the titles, we selected the abstracts of articles that focused on diagnostic issues. Evidence used in this reviewWe searched MEDLINE for articles published from 1950 to 2012 using the search terms “borderline personality disorder” and “diagnosis” or “diagnosis, differential.” Of the 393 studies identified, we excluded case reports, commentaries, editorials, letters and reviews, which left 210 articles in English.
More than 500 000 such visits to emergency departments occur each year in the United States. Unfortunately, a large proportion of patients with the disorder are not identified in practice.Patients with borderline personality disorder are frequently encountered in the emergency department, where they present following threatened suicide or a suicide attempt.
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