Age and clinical presentation of patients at onset of borderline personality disorder in a mental health unit

OjectiveBorderline Personality disorder is a well recognised syndrome. These patients show a clear emotional unstability, lack of control impulse, unpredictible auto and heteroaggresive behaviour, poor interpersonal realitionships and self image as well as brief psychotic episodes.The unspecific symtomatology and diagnostic difficulty derived from different nosographic frames makes their diagnosis and treatment a challenge. Through the analysis of their medical records we aim to know the age they sought specialized help, the symptomatology at first consultation, the treatment given and the outcome after years of therapy.MethodologySystematic review of all BPD patient's medical records treated in our Unit with a particular reference to age and symptoms at the start of treatment and at present. Medical records from the Childhood and Adolescence Psychiatric Unit were also reviewed to determine the most prominent symptoms at that time.ResultsWe found that the vast majority of cases contacted the psychiatric services in their adolescence and early adulthood, probably in relation to demands of daily life at that age. The most relevant symptoms at onset of illness were depressive mood and anxiety. As time went on depressive symptoms were the main complaint. The clinical state remained fairly stable over time.ConclusionsThere is a clear early onset of symptoms, in particular, affective ones (depression and anxiety) being prominent in childhood and preadolescence. Also there is a stable psychopathology over time which keep the patients on long term follow ups. This medical demand seemed to diminish at their fifth decade.