A 28 year-old patient comes to your office for ‘an immediate evaluation’. Your receptionist told him that he was early for his appointment and wanted him to wait for the time of his appointment. But he insisted that he must be seen now. You moved his appointment to his liking to avoid ‘arguments’ and as you talked to him he stated that he needed ‘immediate help because his partner might leave him at any moment now’ because he has heard you are ‘the best doctor in the world’. No matter how much devotion he shows to his partner, he always has a nagging fear of abandonment by his partner. He feels like it is the end of his life if he is abandoned. During the course of a single day, he feels joy, sadness, despair, rage and anxiety. He drinks heavily and binge eats to cope with his mood swings. His social history includes two arrests for reckless driving and for speeding in a school zone. He feels ‘emptiness in my soul’ and contemplated suicide a few times. He reports that his friends are of mixed type, ‘some of them are the best people in the world, while others are the worst on the planet’. He feels ‘lost’ because even though he graduated with summa cum laude, people don’t give him due respect. His friends often ridicule him for rapid mood swings, impulsivity and complain that he sees everything in ‘good and evil’, ‘right and wrong’, and ‘white and black’. In the physical examination of his arms and legs you noticed well healed linear scars from prior episodes of cutting. Patient reports that they are self-inflicted injuries due to feelings of ‘life is not worth living’. After he leaves, the receptionist of your office complains, ‘he is really a difficult patient, who should be terminated from your practice for the sake of all other nice patients’. Regarding this psychological disorder, which of the following statements is true?
