Borderline personality disorder: ontogeny of a diagnosis.
OBJECTIVE
The purpose of this article is to describe the development of the borderline personality disorder diagnosis, highlighting both the obstacles encountered and the associated achievements.


METHODS
On the basis of a review of the literature, the author provides a chronological account of the borderline construct in psychiatry, summarizing progress in decade-long intervals.


RESULTS
Borderline personality disorder has moved from being a psychoanalytic colloquialism for untreatable neurotics to becoming a valid diagnosis with significant heritability and with specific and effective psychotherapeutic treatments. Nonetheless, patients with this disorder pose a major public health problem while they themselves remain highly stigmatized and largely neglected.


CONCLUSIONS
Despite remarkable changes in our knowledge about borderline personality disorder, increased awareness involving much more education and research is still needed. Psychiatric institutions, professional organizations, public policies, and reimbursement agencies need to prioritize this need.
McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA. psychosocial@mcleanpo.mclean.org
John G
JG
Gunderson
D000339:Affect; D001364:Awareness; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003379:Countertransference; D003937:Diagnosis, Differential; D006266:Health Education; D006801:Humans; D011575:Psychoanalytic Therapy / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology