[Problems in diagnosis of borderline disorders in childhood]

Abstract

While, for adults, there exists an instrument for diagnosing borderline-disorders (DSM-III-R, ICD 10), this is not the case for children and adolescents. Several attempts of classifying borderline-disorders are discussed (Bemporad et al., Pine, Vela et al.). Exemplified by a case study of the treatment of a ten-year-old borderline girl originally diagnosed as "hysteria", eight criteria are listed and explained that seem relevant for diagnostic purposes: (1) heredity and affective disorders, (2) diseases and traumata during the first year of life, (3) development in early childhood, (4) character and intensity of anxiety, (5) self-destructiveness, (6) defensive mechanisms, (7) object relationships, (8) countertransference. Attention is drawn to a large-scale empirical study in which, by means of an elaborate questionnaire, child psychiatrists and therapists are asked to characterize symptoms, personality traits and aetiological factors of young borderline patients. This will hopefully solve some problems of differential diagnosis discussed in the article.