What is the role of a mental status exam in the diagnosis of borderline personality disorder (BPD)?

Updated: Nov 05, 2018
  • Author: Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki, MD  more...
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Answer

No consistent physical findings are specific for BPD or borderline pathology in children. Individuals may, however, have scars from self-cutting. The diagnosis is based on clinical observations of behaviors and on patient-reported symptoms.

The mental status examination should include the following:

  • General appearance and behavior - Grooming, height and weight, dress, and any abnormal movements

  • Attitude toward interview, including eye contact

  • Psychomotor activity

  • Range of affect

  • General mood and if it is appropriate to the situation

  • Speech - Rate, volume, and prosody

  • Thought process - Any sign of a thought disorder, thought blocking, flight of ideas, loose associations, or ideas of reference; tangentiality; goal focus

  • Thought content - Obsessions, suicidality, homicidality, or paranoia

  • Hallucinations

  • Delusions

  • Orientation - Person, place, and time

  • Memory - Short- and long-term

  • Attention and concentration

  • Insight and judgment


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