Why borderline personality disorder is neither borderline nor a personality disorder

Abstract

AbstractObjectives Borderline personality disorder is the most well‐studied personality disorder in psychiatry. Despite its great influence in the study of these conditions, it has not been properly recognized that borderline personality disorder is atypical.Design A critical analysis of the differences between borderline and other personality disorders is made.Method A comparison is made between borderline personality disorder and other personality disorders with respect to diagnostic criteria, relationship to normal personality variation and treatment options.Results Analysis of the operational criteria for borderline and schizotypal personality disorders shows that these are the only personality disorders that are dominated by discrete symptoms rather than traits. Cluster analysis of a data set of personality traits obtained between 1976 and 1978 (before borderline personality disorder became fashionable in the UK) could find no profile that supports the existence of a borderline personality disorder grouping, and the study of published papers on treatment in personality disorder shows a 3 : 1 ratio for borderline personality disorder compared with all other personality disorders combined, approaching 9 : 1 when unspecified (probably mainly borderline) conditions are taken into account.Conclusions Borderline personality disorder is incorrectly classified as a personality disorder and does an injustice to those who suffer from it. It is better classified as a condition of recurrent unstable mood and behaviour, or fluxithymia, which is better placed with the mood disorders than in odd isolation as a personality disorder. Copyright © 2009 John Wiley & Sons, Ltd.