The use of the term 'borderline patient' by Scottish psychiatrists: II. Conceptual and descriptive analysis.

Abstract

A descriptive and conceptual analysis of the use of the term 'borderline patient' by Scottish psychiatrists revealed that they view borderline patients as being near the psychotic end of the illness spectrum, with a marked propensity towards brief, reactive, reversible, paranoid or schizophrenic reactions. There is clear evidence that the term is not used to refer to patients who in the United States would be labelled borderline schizophrenic. Individual American diagnostic schemata would omit features held to be of major importance by Scottish psychiatrists when diagnosing borderline patients. In an earlier study, Macaskill and Macaskill (1981) found that the term 'borderline patient' although not in the official nomenclature, was used by over one in four Scottish psychiatrists to delineate a syndrome which they felt should be included in contemporary diagnostic systems because of its prognostic and therapeutic implications. This study provided the first demographic information on the use of the term in the United Kingdom, but did not permit direct comparisons at conceptual and descriptive levels with studies in the United States where the term is widely used and recognised in the official nomenclature of the American Psychiatric Association's Diagnostic and Statistical Manual--III (1980). Research into the use of the term schizophrenia, for example by Cooper et al (1972), has shown that major differences in usage between the United Kingdom and the United States have occurred with serious implications for the cross-cultural validity of research findings in schizophrenia.(ABSTRACT TRUNCATED AT 250 WORDS)