{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T12:00:01Z","timestamp":1781006401997,"version":"3.54.1"},"reference-count":23,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This study aimed to estimate the prevalence of documented borderline personality disorder (BPD) diagnosis and study-defined BPD indicators among adults with depressive disorders in outpatient psychiatric care, and to quantify a subgroup who were indicator-positive but had no documented diagnosis (potential under-recognition). Materials and Methods: This retrospective, cross-sectional study included adult outpatients with depressive disorders receiving pharmacological treatment at Maharaj Nakorn Chiang Mai Hospital. BPD status was classified using (1) a documented BPD diagnosis in the electronic medical record (EMR) and (2) study-defined indicators, comprising a symptom-based indicator (documentation of \u22655 DSM-5 BPD criteria) and a prescribing-based indicator (antidepressant treatment with concurrent use of antipsychotics and\/or mood stabilizers). Prevalence and overlap across diagnoses and indicators were summarized using a Venn distribution. Results: Among 1175 patients, 63 (5.4%) had a documented BPD diagnosis. Using EMR indicators, 84 (7.1%) met the symptom-based indicator and 325 (27.7%) met the prescribing-based indicator. In total, 374 (31.8%) had either a documented BPD diagnosis or at least one indicator, while 801 (68.2%) had neither. Overall, 370 (31.5%) met at least one indicator (symptom-based and\/or prescribing-based). Among indicator-positive patients, 311 (84.1%) had no documented BPD diagnosis, representing 26.5% (311\/1175) of the total cohort. Conclusions: Study-defined EMR indicators flagged a substantial subgroup with potential under-recognition of BPD features in depressive-disorder clinics. These indicators may help prioritize targeted assessment and structured diagnostic evaluation to support access to BPD-informed care and support referral to BPD-informed psychotherapy.<\/jats:p>","DOI":"10.3390\/medicina62061120","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T09:46:54Z","timestamp":1780998414000},"page":"1120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Documented Borderline Personality Disorder and EMR Indicators of Potential Under-Recognition in Depressive Outpatients"],"prefix":"10.3390","volume":"62","author":[{"given":"Lifang","family":"Dang","sequence":"first","affiliation":[{"name":"Mental Health Program, Multidisciplinary and Interdisciplinary School (MIdS), Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8367-5260","authenticated-orcid":false,"given":"Shun Lei","family":"Oo","sequence":"additional","affiliation":[{"name":"Mental Health Program, Multidisciplinary and Interdisciplinary School (MIdS), Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8365-2474","authenticated-orcid":false,"given":"Nahathai","family":"Wongpakaran","sequence":"additional","affiliation":[{"name":"Mental Health Program, Multidisciplinary and Interdisciplinary School (MIdS), Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5878-9620","authenticated-orcid":false,"given":"Awirut","family":"Oon-arom","sequence":"additional","affiliation":[{"name":"Mental Health Program, Multidisciplinary and Interdisciplinary School (MIdS), Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4534-8046","authenticated-orcid":false,"given":"Rewadee","family":"Jenraumjit","sequence":"additional","affiliation":[{"name":"Mental Health Program, Multidisciplinary and Interdisciplinary School (MIdS), Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"DeMaranville","sequence":"additional","affiliation":[{"name":"Mental Health Program, Multidisciplinary and Interdisciplinary School (MIdS), Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9062-3468","authenticated-orcid":false,"given":"Tinakon","family":"Wongpakaran","sequence":"additional","affiliation":[{"name":"Mental Health Program, Multidisciplinary and Interdisciplinary School (MIdS), Chiang Mai University, Chiang Mai 50200, Thailand"},{"name":"Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"ref_1","unstructured":"APA (2013). 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