Psychiatry
Emotionally Unstable Personality Disorder Management
NICE CG78 — psychological therapy first-line (DBT, MBT, schema-focused), avoid medication for primary symptoms, manage crisis, treat comorbidity.
Source: NICE CG78 (2009, reviewed)
Step 1 of ~4
info
Diagnose
EUPD (UK / ICD-11) = Borderline Personality Disorder (DSM-5).
DSM-5: pervasive instability of interpersonal relationships, self-image, affect + impulsivity from early adulthood, ≥5 of:
• Frantic efforts to avoid abandonment.
• Unstable intense interpersonal relationships.
• Identity disturbance.
• Impulsivity in ≥2 self-damaging areas.
• Recurrent suicidal behaviour, gestures, threats, self-mutilating.
• Affective instability.
• Chronic feelings of emptiness.
• Inappropriate intense anger / difficulty controlling anger.
• Transient, stress-related paranoid ideation / dissociation.
High comorbidity: depression (>80%), substance use (50%), eating disorder, PTSD.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Ethambutol · Antitubercular — First-Line TB (RIPE Regimen, 'E')
- Pyrazinamide · Antitubercular — First-Line TB (RIPE Regimen, 'P')
- Ethinylestradiol with levonorgestrel · Combined oral contraceptive (2nd-generation progestogen — first-line)
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Midazolam (Paediatric) · Benzodiazepine — Status Epilepticus (First-Line) / Procedural Sedation
- Alglucosidase Alfa · Enzyme Replacement Therapy (Lysosomal Storage Disorder)
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF
Decision support only. Always apply local guidelines and clinical judgement.