Emotionally unstable personality disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Emotionally Unstable Personality Disorder is a medical diagnosis equivalent to Borderline personality disorder but belonging to the ICD-10 system of classification. The diagnostic criteria differ slightly from that of the DSM-IV-TR system used by the American Psychiatric Association.

ICD-10 diagnostic criteria

F60.30 Impulsive type

1. The general criteria for personality disorder (F60) must be met. [see below]
2. At least three of the following must be present, one of which must be (2):
   1. marked tendency to act unexpectedly and without consideration of the consequences;
   2. marked tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or criticized;
   3. liability to outbursts of anger or violence, with inability to control the resulting behavioural explosions;
   4. difficulty in maintaining any course of action that offers no immediate reward;
   5. unstable and capricious mood.

F60.31 Borderline type

1. The general criteria for personality disorder (F60) must be met. [see below]
2. At least three of the symptoms mentioned in criterion 2 for F60.30 must be present [see above], with at least two of the following in addition:
   1. disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual);
   2. liability to become involved in intense and unstable relationships, often leading to emotional crisis;
   3. excessive efforts to avoid abandonment;
   4. recurrent threats or acts of self-harm;
   5. chronic feelings of emptiness.

F60 Disorders of adult personality and behaviour

1. There is evidence that the individual's characteristic and enduring patterns of inner experience and behaviour as a whole deviate markedly from the culturally expected and accepted range (or "norm"). Such deviation must be manifest in more than one of the following areas:
   1. cognition (i.e. ways of perceiving and interpreting things, people, and events; forming attitudes and images of self and others);
   2. affectivity (range, intensity, and appropriateness of emotional arousal and response);
   3. control over impulses and gratification of needs;
   4. manner of relating to others and of handling interpersonal situations.
2. The deviation must manifest itself pervasively as behaviour that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e. not being limited to one specific "triggering" stimulus or situation).
3. There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behaviour referred to in criterion 2.
4. There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.
5. The deviation cannot be explained as a manifestation or consequence of other adult mental disorders, although episodic or chronic conditions from sections F00-F59 or F70-F79 of this classification may coexist with, or be superimposed upon, the deviation.
6. Organic brain disease, injury, or dysfunction must be excluded as the possible cause of the deviation. (If an organic causation is demonstrable, category F07.- should be used.)