Unifying Concepts

Criteria for the Diagnosis of Borderline Personality Disorder (BPD)

Borderline personality disorder is a chronic psychiatric disorder characterized by marked impulsivity, instability of mood and interpersonal relationships, and suicidal behaviour that can complicate medical care. Identifying this diagnosis is important for treatment planning.

Criteria for the Diagnosis of Borderline Personality Disorder
Five or more of the following criteria must be met:
Interpersonal hypersensitivity

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense interpersonal relationships, characterized by alternating between extremes of idealization and devaluation

Affective dysregulation

  • Affective instability because of a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety, usually lasting a few hours and only rarely more than a few days)
  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  • Chronic feelings of emptiness


  • Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending money, sex, substance abuse, reckless driving, binge eating)
  • Recurrent suicidal behavior, gestures, or threats or self-mutilating behavior

Other factors

  • Identity disturbance with markedly and persistently unstable self-image or sense of self
  • Transient, stress-related paranoid ideation or severe dissociative symptoms



  1. Gunderson JG. Clinical practice. Borderline personality disorder. N Engl J Med. 2011 May 26;364(21):2037-42 [Medline]
  2. Paris J. Borderline personality disorder. CMAJ. 2005 Jun 7;172(12):1579-83 [Medline]


Created: May 26,2011

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