Question

A 25 year old female was brought to the casualty after she allegedly attempted suicide, with her wrists slashed. She has a past history of difficulty in maintaining interpersonal relationships and also recurrent mood fluctuation episodes. What is the most likely diagnosis?

• A. Depression
• B. Borderline personality disorder
• C. Histrionic personality
• D. Schizophrenia

Hint:

Long standing unstable relationships plus mood swings plus impulsive self harm such as wrist slashing point to borderline personality disorder, not a single depressive episode.

Answer 1

The Correct Option is B

Step 1: Understanding the Concept:
This question checks whether a single suicide attempt should be read as an isolated mood crisis or as part of a longer standing personality pattern.

Step 2: Key Approach:
Look at the timeline: does the history describe a pattern going back over years, or a recent change in mood only. Then match the pattern to the option that best explains both the self harm and the background history.

Step 3: Detailed Explanation:
The question gives two long standing features, difficulty keeping relationships stable and recurrent episodes of mood swings, which describe a pattern of functioning over time, not a single recent illness.
Add to that an impulsive act of self harm, the wrist slashing, and the full picture matches the diagnostic markers of borderline personality disorder: unstable relationships, affective instability, and repeated self harming or suicidal acts.
If this were depression alone, we would expect a continuous low mood and loss of interest lasting weeks, not a background of repeated ups and downs stretching further back plus a chronic relationship problem.
Histrionic personality would show dramatic, attention seeking behavior as the main feature, but it does not carry the same strong link to repeated self harm and identity or relationship instability that this vignette describes.
Schizophrenia is ruled out because there is no mention of hallucinations, delusions, or disorganised speech or behavior anywhere in the history.

Step 4: Final Answer:
The long term relationship difficulty, repeated mood swings, and impulsive wrist slashing together point to borderline personality disorder.