Question

A 16 year old girl was brought to the psychiatric emergency after she slashed her wrists in a suicide attempt. On enquiry, her father revealed that she had made several such wrist-slashing attempts in the past, mostly in response to trivial fights at home. She also has marked mood fluctuations with a pervasive pattern of unstable interpersonal relationships. What is the most probable diagnosis?

• A. Borderline personality disorder
• B. Major depression
• C. Histrionic personality disorder
• D. Adjustment disorder

Hint:

Repeated impulsive self-harm plus unstable mood and relationships in a teenager points to borderline personality disorder.

Answer 1

The Correct Option is A

Step 1: Understanding the Question:
A 16 year old girl has repeated wrist-slashing episodes, often triggered by minor conflicts at home, along with marked mood swings and a long-standing pattern of unstable relationships. We need the personality pattern that best explains this.

Step 2: Key Concept:
Borderline personality disorder is defined by a pervasive pattern of instability in relationships, self-image, and mood, along with marked impulsivity, including repeated self-harm or suicidal behaviour, that begins by early adulthood and shows up across many situations.

Step 3: Detailed Explanation:
The recurring wrist-slashing in response to small arguments is a form of impulsive self-harm, which is a core feature of borderline personality disorder, and the pervasive unstable relationships and mood swings match the diagnosis directly.
Major depression can bring on a single suicide attempt during a depressive episode, but it does not typically explain a long pattern of repeated self-harm tied to minor relationship conflict, or the pervasive instability of relationships described here.
Histrionic personality disorder centers on excessive attention seeking, dramatic and shallow emotional expression, and a need to be the center of attention, not primarily on repeated self-harm and unstable relationships.
Adjustment disorder is a short-term reaction to a specific identifiable stressor, not a longstanding pattern that has repeated itself many times over a period.

Step 4: Final Answer:
The most probable diagnosis is borderline personality disorder.
\[ \boxed{\text{Borderline personality disorder}} \]