Affective instability – repeated, rapid, and abrupt shiftsin mood – should be used as a ‘gate criterion’ for borderline personalitydisorder (BPD), and could address the historic under-recognition of thedisorder, a paper has proposed.
The paper, published in TheBritish Journal of Psychiatry, recommends that the presence of affectiveinstability in patients be used to screen for BPD. The paper notes that whilethere are currently ‘gate’ criteria in place for conditions such as generalisedanxiety disorder, substance abuse disorder and panic disorder, there is no suchsystem for detecting BPD.
The paper concludes that if a patient has a lot of suddenchanges in mood, this will identify BPD in the vast majority of cases.Conversely, if a patient does not experience this problem, they are unlikely tohave BPD.
Borderline personality disorder is a serious mental healthcondition resulting in high levels of emotional distress, reducedhealth-related quality of life, high use of services and excess mortality. Theunder-recognition of BPD has been identified as a significant clinical problem.It is hoped, therefore, that these findings will result in the improvedefficacy of diagnosis when screening for BPD.
Dr Mike Crawford from the Royal College of Psychiatristssaid: “It takes time to get to understand a person’s personality. But theresults of this study suggest that asking people about sudden changes in moodis a good starting point for assessing whether they may have borderlinepersonality disorder. This is important to help ensure that people receiveeffective treatment and avoid treatments that do not work.”
