Biol Psychiatry. 2008 Oct 15;64(8):653-9. Epub 2008 Jun 12.

The case for shifting borderline personality disorder to Axis I.

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Department of Psychiatry, Mount Sinai School of Medicine, New York, New York 10029, USA. antonia.new@mssm.edu

Abstract

Through reviewing what is known about the nature, course, and heritability of borderline personality disorder (BPD), we argue for a reconceptualization of this disorder that would lead to its placement on Axis I. Borderline personality disorder is a prevalent and disabling condition, and yet the empirical research into its nature and treatment has not been commensurate with the seriousness of the illness. We not only review empirical evidence about the etiology, phenomenology, and course of the disorder in BPD but we also address fundamental misconceptions about BPD that we believe have contributed to misunderstanding and stigmatization of the disease. Finally, we suggest future directions for research that might permit the identification of core features of this disorder, with a focus on the importance of naturalistic assessments and of assessments through the course of development.

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