What do general adult psychiatry patients think we should call borderline personality disorder?: A cross-sectional study to find the most acceptable diagnostic term

David Hayward; Amy Fourie; Donald J. MacIntyre; Douglas Steele

doi:10.1192/bjb.2025.10128

What do general adult psychiatry patients think we should call borderline personality disorder? A cross-sectional study to find the most acceptable diagnostic term

David Hayward (Lead / Corresponding author)
, Amy Fourie
, Donald J. MacIntyre
, Douglas Steele

Neuroscience

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

118 Downloads (Pure)

Abstract

Aims and method To determine the most acceptable term for borderline personality disorder (BPD). We conducted a cross-sectional study of patients who know what it feels like to be diagnosed with a mental disorder. The main outcome measures were the proportion of participants offended and confused by alternative terms for BPD. Results Seventy-two people participated in the study. Being diagnosed with a condition was more offensive than being diagnosed with a disorder (χ 2 = 41.18, d.f. = 1, P < 0.01). Fluxithymia offended the fewest participants (13%), but was the most confusing term (31%). Emotionally unstable personality disorder was the most offensive term (63%). After fluxithymia, emotional intensity disorder was the least offensive term, and not especially confusing (11%). Changing BPD to emotional intensity disorder would avoid an offensive event every 3.6 diagnostic announcements. Clinical implications The diagnostic term BPD should be replaced with emotional intensity disorder, because this term provides a balance of clarity and inoffensiveness.

Original language	English
Number of pages	5
Journal	BJPsych Bulletin
DOIs	https://doi.org/10.1192/bjb.2025.10128
Publication status	Published - 19 Aug 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Stigma and discrimination
Patients and service users
General adult psyciatry
borderline personality disorder
patient and public involvement
emotional intensity disorder
stigma
diagnostic terminology
Borderline personality disorder

ASJC Scopus subject areas

Psychiatry and Mental health

Access to Document

10.1192/bjb.2025.10128Licence: CC BY

Final Published VersionFinal published version, 300 KBLicence: CC BY

Cite this

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title = "What do general adult psychiatry patients think we should call borderline personality disorder?: A cross-sectional study to find the most acceptable diagnostic term",

abstract = "Aims and method To determine the most acceptable term for borderline personality disorder (BPD). We conducted a cross-sectional study of patients who know what it feels like to be diagnosed with a mental disorder. The main outcome measures were the proportion of participants offended and confused by alternative terms for BPD. Results Seventy-two people participated in the study. Being diagnosed with a condition was more offensive than being diagnosed with a disorder (χ 2 = 41.18, d.f. = 1, P < 0.01). Fluxithymia offended the fewest participants (13\%), but was the most confusing term (31\%). Emotionally unstable personality disorder was the most offensive term (63\%). After fluxithymia, emotional intensity disorder was the least offensive term, and not especially confusing (11\%). Changing BPD to emotional intensity disorder would avoid an offensive event every 3.6 diagnostic announcements. Clinical implications The diagnostic term BPD should be replaced with emotional intensity disorder, because this term provides a balance of clarity and inoffensiveness.",

keywords = "Stigma and discrimination, Patients and service users, General adult psyciatry, borderline personality disorder, patient and public involvement, emotional intensity disorder, stigma, diagnostic terminology, Borderline personality disorder",

author = "David Hayward and Amy Fourie and MacIntyre, \{Donald J.\} and Douglas Steele",

note = "{\textcopyright} The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists ",

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AU - Fourie, Amy

AU - MacIntyre, Donald J.

AU - Steele, Douglas

N1 - © The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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N2 - Aims and method To determine the most acceptable term for borderline personality disorder (BPD). We conducted a cross-sectional study of patients who know what it feels like to be diagnosed with a mental disorder. The main outcome measures were the proportion of participants offended and confused by alternative terms for BPD. Results Seventy-two people participated in the study. Being diagnosed with a condition was more offensive than being diagnosed with a disorder (χ 2 = 41.18, d.f. = 1, P < 0.01). Fluxithymia offended the fewest participants (13%), but was the most confusing term (31%). Emotionally unstable personality disorder was the most offensive term (63%). After fluxithymia, emotional intensity disorder was the least offensive term, and not especially confusing (11%). Changing BPD to emotional intensity disorder would avoid an offensive event every 3.6 diagnostic announcements. Clinical implications The diagnostic term BPD should be replaced with emotional intensity disorder, because this term provides a balance of clarity and inoffensiveness.

AB - Aims and method To determine the most acceptable term for borderline personality disorder (BPD). We conducted a cross-sectional study of patients who know what it feels like to be diagnosed with a mental disorder. The main outcome measures were the proportion of participants offended and confused by alternative terms for BPD. Results Seventy-two people participated in the study. Being diagnosed with a condition was more offensive than being diagnosed with a disorder (χ 2 = 41.18, d.f. = 1, P < 0.01). Fluxithymia offended the fewest participants (13%), but was the most confusing term (31%). Emotionally unstable personality disorder was the most offensive term (63%). After fluxithymia, emotional intensity disorder was the least offensive term, and not especially confusing (11%). Changing BPD to emotional intensity disorder would avoid an offensive event every 3.6 diagnostic announcements. Clinical implications The diagnostic term BPD should be replaced with emotional intensity disorder, because this term provides a balance of clarity and inoffensiveness.

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