MCQ – 87937

1. A 29 year old woman presents to clinic complaining of mood swings over the past few years.She never thought they were that bad,but she believes that her last episode was behind her being fired from job,so she decided to seek help.Most of her mood swings relate to her romantic relationships.She says she can feel “on cloud nine” one day & then unloved & useless the other day.She has been through 6 boyfriends in the last 10 years & no relationship lasts longer than a year despite the fact that she says she wants a long term relationship.Her previous relationship ended when her boyfriend said she was clingy & manipulative which caused the patient to go into a deep depression for several months during which she isolated herself & cut her forearms with a knife,which she says made her feel somewhat better.She says she frequently feels fear of abandonment ever since she was a child.She is on no medications but she has a relevant history of suicide attempts when she was 24.Physical examination is remarkable of scars on her forearm.She reports feeling of guilt & emptiness in relation to her last relationship ending.She reports good sleep,denies suicidal ideation.Appetite,concentration & energy are reported normal.Which of the following is most likely diagnosis?

Correct Answer � C Explanation

Ans-C-Borderline personality disorder

Explanation-There is no signs of mania or hypomania in the given history,Hence option A & B can be eliminated.

The depressive symptoms should last for at least 2 weeks to diagnose it as a major depressive disorder,but she is reporting her apatite,sleep as normal with no suicidal tendencies

Borderline personality disorder main characteristics are:

1. Heightened fear of abandonment

2. Frequent feeling of loneliness & emptiness

3. Dramatic sometimes unpredictable mood swings

4. Unstable relationships

5. Impulsivity

6. Suicidal thoughts

7. Non suicidal self harm