Borderline personality: Different symptoms in different treatment settings?

OBJECTIVE: As described in DSM-IV, borderline personality disorder (BPD) is a polysymptomatic disorder characterized by multiple and diverse psychological symptoms. In our experience, this symptomatic diversity may manifest as various somatic presentations in primary care settings. Through a review of the existing empirical literature and case reports, we undertook this study to evaluate the possible relationship between BPD and various somatic symptoms. METHOD: Using PubMed and PsycINFO databases, we embarked on a literature search to locate published papers on the relationship between BPD and various somatic symptoms. RESULTS: While sparse in number, we located several studies and case reports in this area. Despite the methodological limitations (e.g. method of BPD diagnosis, small sample sizes), available empirical studies suggest an association between BPD and somatic symptoms among some patients. CONCLUSION: Among some patients in primary care settings, somatic presentations may relate to a diagnosis of BPD. We discuss these findings in terms of a bifurcation hypothesis.