Borderline personality disorder: a case report

Abstract

Borderline personality disorder (BPD) is defined in the DSM-5 as a pattern of instability in interpersonal relationships, self-image and affect, with intense impulsivity; it is the most frequent personality disorder, more prevalent in women, and with high representation in hospitalized and incarcerated populations. We present the case of a 32-year-old woman admitted to an acute unit, referred for an atypical depressive picture with a poor response and self-aggressive risk, in the context of her own work problems and the dismissal of her husband, with marked emotional lability, low self-esteem, self-demand, insomnia and self-aggressive behaviour. After assessment according to Marjory Gordon’s functional health patterns, a care plan was developed with the NANDA, NOC and NIC taxonomies (ineffective coping, chronic low self-esteem and self-mutilation). During admission, the patient was instructed in strategies to control self-injurious impulses (such as cold showers), which reduced self-harm, and after two months she was referred to a day hospital to continue work on chronic low self-esteem, emphasizing that the management of BPD is a challenge for mental health nursing.