A young lady was admitted after taking overdose of diazepam after broken affair, she has history of slitting her wrist previously. Most likely diagnosis:
Correct Answer: Borderline personality disorder
Description: Ans. is 'c' Borderline personality disorder Following points favour the diagnosis of Borderline personality disorderImpulsive behaviourUnstable emotional responsesSuicidal attemptsBorderline and Histrionic Personality disorder have been described earlier. Lets see other personality disorders-Dependent personality disorder -It denotes a chronic excessive dependence on others. Such pts frequently defer decision making to others. They tolerate mistreatment, place other needs before own and have difficulty being assertive. pts also demonstrate low self esteem, insecurity and longing to be in a relationship.Example:"A 49 year old female, a housewife complains of sadness d/t break up of her marriage. She states that she feels insecure when left on her own and has great difficulty asserting herself She adds that she considers herself a follower' who has left all decision making to her husband. She describes her husband as an intense and domineering man. She has met through her husband ANarcissistic Personality disorderCharacterstic features -Ideas of grandiosity and inflated sense of self importance.Preoccupation with fantasies of unlimited success.Attention seeking dramatic behaviour, needs constant praiseShaky self-esteem, underlying sense of inferiority which is compensated by creating an image of power, wealth and attractiveness.It denotes a chronic excessive dependence on others. Such pts frequently defer decision making toExample- "A 45yr. old man is admitted to the medical unit following a heart attack, a psychiatry consultant is requested when nurses report that his offensive behavior is disrupting the staff and other patients. When questioned, the patient is dismissive and prefers instead to discuss his (beautiful girlfriends) new sports car, widespread influence. He denies having had a heart attack and claims that it was just 'minor heartburn'."
Category:
Psychiatry
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