Abstract
BACKGROUND: Borderline Personality Disorder (BPD) in adolescents is a complex, often under-recognized psychiatric condition characterized by the emotional dysregulation, impulsivity, unstable self-image, and difficulties in relationships. AIM: To explore the clinical and sociodemographic characteristics of BPD in adolescents, as well as associated factors and management strategies. MATERIALS AND METHODS: A cross-sectional study was conducted at the outpatient department of a tertiary care Institute of Mental Health and Neurosciences from November 2024 to January 2025. A total of 71 adolescents aged 9 to 18 years were assessed using the Borderline Personality Features Scale for Children-11 Self-Report (BPFSC) and the DSM-5 criteria for BPD. RESULTS: Results revealed a predominance of female participants (95.77%), with an average age of symptom onset at 14.97 years and an average age of presentation at 16.87 years. The most common presenting symptoms, included impulsivity (90.14%), affective instability (80.28%), and intense anger (78.87%), while identity disturbance was the less frequently observed (8.45%). Familial conflict was the most common predisposing factor (36.61%), with Major Depressive Disorder (MDD) as the most frequent comorbidity (11.26%). Psychotherapy was universally prescribed, with low-dose quetiapine (28.16%) and sertraline (26.76%) being the most used pharmacotherapies. CONCLUSION: The findings highlight the importance of recognizing the early manifestation of BPD traits, particularly in those at high risk for developing the full disorder. Recognizing BPD as a significant, but often overlooked condition in adolescents is essential to mitigate its impact and improving the quality of life for affected individuals making early identification and intervention a necessity.