Borderline Personality Disorder: A Comprehensive Review of Current Diagnostic Practices, Treatment Modalities, and Key Controversies

Cureus. 2024 Dec 17;16(12):e75893. doi: 10.7759/cureus.75893. eCollection 2024 Dec.

Abstract

Borderline personality disorder (BPD) is a complex psychiatric condition characterized by pervasive patterns of instability in emotions, interpersonal relationships, and self-image. This comprehensive review explores the current diagnostic practices, treatment modalities, and ongoing controversies surrounding BPD. We discuss established and proposed diagnostic criteria, highlight the limitations of current assessment tools, and examine the epidemiology of the disorder, including its prevalence and comorbidities. The effectiveness of psychotherapeutic approaches such as dialectical behavior therapy, mentalization-based treatment, transference-focused psychotherapy, and schema-focused psychotherapy is evaluated alongside the role of pharmacological interventions. Furthermore, we address critical controversies, including misdiagnosis, the impact of trauma, stigma, and the ongoing debate regarding the treatability and recovery potential for individuals with BPD. By synthesizing these facets, we aim to provide a nuanced understanding of BPD and inform future research and clinical practice.

Keywords: borderline personality disorder; dialectical behavior therapy; mentalization-based treatment; schema-focused psychotherapy; transference-focused psychotherapy.

Publication types

  • Review