What are the key diagnostic criteria for Borderline Personality Disorder according to NICE guidelines?

Key diagnostic criteria for Borderline Personality Disorder (BPD) according to NICE guidelines are not explicitly listed as a discrete set of criteria within the provided NICE guideline excerpts. However, NICE highlights clinical features that should prompt consideration of BPD diagnosis, especially in primary care and community mental health settings.

These include:

• Repeated self-harm or persistent risk-taking behaviour.
• Marked emotional instability.
• Significant distress or risk to self or others that may require specialist assessment.

When these features are present, referral to community mental health services (or CAMHS for those under 18) for comprehensive assessment is recommended. The assessment should include evaluation of psychosocial and occupational functioning, coping strategies, comorbid mental disorders, social problems, and the need for psychological treatment and support.

Thus, NICE recommends a clinical judgement-based approach focusing on behavioural patterns (self-harm, risk-taking), emotional dysregulation, and functional impairment rather than a strict checklist of diagnostic criteria.

This approach aligns with the need for specialist mental health teams to conduct thorough assessments to confirm diagnosis and plan management.

In summary: Key diagnostic indicators prompting assessment for BPD are repeated self-harm, persistent risk-taking behaviour, and marked emotional instability, with diagnosis confirmed through specialist assessment considering broader psychosocial context and comorbidities ¹.