Garikana Sarah, Jain Pratik, Megna James L, Leontieva Luba
Psychiatry, State University of New York Upstate Medical University, Syracuse, USA.
Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, USA.
Cureus. 2024 Feb 28;16(2):e55166. doi: 10.7759/cureus.55166. eCollection 2024 Feb.
In this paper, we report an atypical presentation of borderline personality disorder (BPD) in a 30-year-old female with a history of childhood molestation and trauma and a prior diagnosis of post-traumatic stress disorder (PTSD). The patient was hospitalized due to anxiety, depression, and guilt over her relapse into alcohol use disorder. During her hospital stay, we diagnosed her with BPD based on psychiatric examination, clinical interviews, and patient history. While the patient exhibited some of the typical characteristics of BPD, such as an instability of interpersonal and romantic relationships, there were numerous findings that were atypical of BPD. These include a demonstration of mature defense mechanisms such as sublimation and altruism, high levels of occupational functioning, strong maternal caregiving behavior, and no history of self-harm. Further analysis of the patient's personality traits helped us identify that this presentation could be best characterized as a high-functioning internalizing subtype of BPD as identified in prior literature.
在本文中,我们报告了一名30岁女性边缘性人格障碍(BPD)的非典型表现。该女性有童年期受虐和创伤史,之前被诊断为创伤后应激障碍(PTSD)。患者因焦虑、抑郁以及对复发性酒精使用障碍感到内疚而住院。在她住院期间,我们通过精神检查、临床访谈和患者病史诊断她患有BPD。虽然患者表现出一些BPD的典型特征,如人际关系和恋爱关系不稳定,但也有许多非BPD的典型表现。这些表现包括展现出成熟的防御机制,如升华和利他主义、高水平的职业功能、强烈的母性照料行为以及无自伤史。对患者人格特质的进一步分析帮助我们确定,这种表现最能被描述为先前文献中所确定的BPD高功能内化亚型。