Distinguishing between ICD-11 complex post-traumatic stress disorder and borderline personality disorder: clinical guide and recommendations for future research

Thanos Karatzias; Martin Bohus; Mark Shevlin; Philip Hyland; Jonathan I Bisson; Neil Roberts; Marylène Cloitre

doi:10.1192/bjp.2023.80

Distinguishing between ICD-11 complex post-traumatic stress disorder and borderline personality disorder: clinical guide and recommendations for future research

Br J Psychiatry. 2023 Sep;223(3):403-406. doi: 10.1192/bjp.2023.80.

Authors

Thanos Karatzias¹, Martin Bohus², Mark Shevlin³, Philip Hyland⁴, Jonathan I Bisson⁵, Neil Roberts⁶, Marylène Cloitre⁷

Affiliations

¹ School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK; and NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK.
² Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany; Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; and McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA.
³ School of Psychology, Ulster University, Londonderry, Northern Ireland.
⁴ Department of Psychology, Maynooth University, Kildare, Ireland.
⁵ School of Medicine, Cardiff University, Cardiff, UK.
⁶ School of Medicine, Cardiff University, Cardiff, UK; and Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK.
⁷ National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA; and Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA.

PMID: 37381070
DOI: 10.1192/bjp.2023.80

Abstract

Although complex post-traumatic stress disorder and borderline personality disorder are distinct disorders, there is confusion in clinical practice regarding the similarities between the diagnostic profiles of these conditions. We summarise the differences in the diagnostic criteria that are clinically informative and we illustrate these with case studies to enable diagnostic accuracy in clinical practice.

Keywords: Comorbidity; education and training; personality disorders; post-traumatic stress disorder; trauma.

MeSH terms

Borderline Personality Disorder* / diagnosis
Borderline Personality Disorder* / epidemiology
Comorbidity
Confusion
Diagnostic and Statistical Manual of Mental Disorders
Humans
International Classification of Diseases
Stress Disorders, Post-Traumatic* / diagnosis
Stress Disorders, Post-Traumatic* / epidemiology