ICD-10 Criteria for Borderline Personality Disorder
The ICD-10 Classification of Mental and Behavioural Disorders World Health Organization, Geneva, 1992
emotionally unstable personality disorder
explosive
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ICD-10

Criteria for Borderline Personality Disorder

The ICD-10 Classification of Mental and Behavioural Disorders World Health Organization, Geneva, 1992

F60.3 Emotionally Unstable (Borderline) Personality Disorder

A personality disorder in which there is a marked tendency to act impulsively without consideration of the consequences, together with affective instability. The ability to plan ahead may be minimal, and outbursts of intense anger may often lead to violence or "behavioural explosions"; these are easily precipitated when impulsive acts are criticized or thwarted by others. Two variants of this personality disorder are specified, and both share this general theme of impulsiveness and lack of self-control.

Impulsive type:
The predominant characteristics are emotional instability and lack of impulse control. Outbursts of violence or threatening behaviour are common, particularly in response to criticism by others.

Includes: 
* explosive and aggressive personality (disorder) 

Excludes: 
* dissocial personality disorder

Borderline type:
Several of the characteristics of emotional instability are present; in addition, the patient's own self-image, aims, and internal preferences (including sexual) are often unclear or disturbed. There are usually chronic feelings of emptiness. A liability to become involved in intense and unstable relationships may cause repeated emotional crises and may be associated with excessive efforts to avoid abandonment and a series of suicidal threats or acts of self-harm (although these may occur without obvious precipitants). 

Includes: 
* borderline personality (disorder)

Personality Disorders

A personality disorder is a severe disturbance in the characterological constitution and behavioural tendencies of the individual, usually involving several areas of the personality, and nearly always associated with considerable personal and social disruption. Personality disorder tends to appear in late childhood or adolescence and continues to be manifest into adulthood. It is therefore unlikely that the diagnosis of personality disorder will be appropriate before the age of 16 or 17 years. General diagnostic guidelines applying to all personality disorders are presented below; supplementary descriptions are provided with each of the subtypes.

Diagnostic Guidelines

Conditions not directly attributable to gross brain damage or disease, or to another psychiatric disorder, meeting the following criteria: 

(a) markedly dysharmonious attitudes and behaviour, involving usually several areas of functioning, e.g. affectivity, arousal, impulse control, ways of perceiving and thinking, and style of relating to others; 
(b) the abnormal behaviour pattern is enduring, of long standing, and not limited to episodes of mental illness; 
(c) the abnormal behaviour pattern is pervasive and clearly maladaptive to a broad range of personal and social situations; 
(d) the above manifestations always appear during childhood or adolescence and continue into adulthood; 
(e) the disorder leads to considerable personal distress but this may only become apparent late in its course; 
(f) the disorder is usually, but not invariably, associated with significant problems in occupational and social performance.

For different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations. For diagnosing most of the subtypes listed below, clear evidence is usually required of the presence of at least three of the traits or behaviours given in the clinical description. 

Does the ICD 10 classification accurately describe subtypes of borderline personality disorder?

Br J Med Psychol. 2000 Dec;73 Pt 4:483-94. 
Whewell P, Ryman A, Bonanno D, Heather N.
Newcastle City Health NHS Trust, Regional Department of Psychotherapy, Newcastle upon Tyne, UK.

"The aim of the paper is to explore whether the division of borderline personality disorder, as described in the DSM classification, into impulsive and borderline subtypes of emotionally unstable personality disorder in the ICD classification of personality disorder, is a valid division. The self-report questionnaire responses of 288 referrals to a personality disorder service were rated on each of the eight criteria for DSM-III-R diagnosis of borderline personality disorder. Factor analysis identified two factors; factor one closely corresponds with the borderline subtype of ICD10, whilst factor two closely corresponds with the impulsive subtype of ICD10. Criteria common to both factors unstable relationships and identity confusion - were considered core features of borderline personality disorder. The pattern of occurrence of the two factors was similar to the complex binary picture described by ICD10. However there were also differences. Firstly, identity confusion is found to be a core feature of both our factors, and this does not conform to the restriction of identity confusion to the borderline subtypes in ICD10. Secondly, we found a residual pool of undifferentiated borderline patients and a small group of pure non-impulsive borderline patients who are not currently accommodated within the ICD10 emotionally unstable personality disorder. We conclude that future classifications of this disorder should accommodate four subtypes, and suggest these subtypes have implications for treatment and further research."
PubMed

ICD-10 copyright � 1992 by World Health Organization.
This material is for educational purposes only,


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