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Clinical Crossroads |

A 44-Year-Old Woman With Borderline Personality Disorder

John M. Oldham, MD, Discussant
JAMA. 2002;287(8):1029-1037. doi:10.1001/jama.287.8.1029.
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Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.

DR BURNS: Ms J is a 44-year-old woman with a history of borderline personality disorder. She lives alone and currently works full-time as a residential counselor in the mental health field. She purchases Medicaid-type insurance through Common Health in Massachusetts. She initially came to see Dr M in July 2000 because she was unhappy with her previous primary care physician.

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Figure. Balance of Combined Treatment According to Type of Borderline Personality Disorder
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For each type of borderline personality disorder, a combination of psychotherapy and pharmacotherapy is indicated. Reliance on pharmacotherapy will be greater, particularly early in the course of treatment, for types 1-3 until affect regulation and impulse control have stabilized. Adapted with permission from American Psychiatric Publishing Inc.7

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