Meeting abstract

https://doi.org/10.24869/spsih.2026.198

Clinical Similarities, Therapeutic Differences: ADHD and Borderline Personality Disorder in Adults

Lucija Seleš ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia *
Andrea Botica ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Marijeta Ivandić ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Žana Kralj ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Milena Pernat ; University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia

* Corresponding author.

Abstract

Objectives: Numerous similarities between borderline
personality disorder and attention-deficit/
hyperactivity disorder (ADHD) in adults
make it difficult to distinguish between these two
disorders. ADHD is a neuropsychiatric disorder
of childhood and adolescence characterized by
a triad of symptoms: hyperactivity, impulsivity,
and impaired attention. It is a chronic disorder,
and in more than half of cases the symptoms are
also present in adulthood, most commonly as
difficulty completing tasks, inner restlessness,
lowered frustration tolerance, mood lability, and
a tendency toward risky behavior. Borderline personality
disorder emerges in late adolescence or
early adulthood. It is characterized by persistent
patterns of instability and hypersensitivity in interpersonal
relationships, impulsive actions without
consideration of consequences, and emotional
instability accompanied by outbursts of anger,
including aggressive behaviors. The diagnoses of both disorders are based on clinical criteria. The
aim of this study is to demonstrate that, despite
many similarities in clinical presentation, different
approaches in psychopharmacotherapy are
required. Accurate diagnosis and choice of treatment
have a positive effect on social and occupational
functioning.
Materials and methods: We present the cases of
two patients whose clinical pictures are dominated
by impulsivity, restlessness, difficulties in
emotion regulation, a lowered frustration threshold,
and problems in everyday functioning. Both
patients underwent psychological testing. The
first patient is a 31‑year‑old man who met the
criteria for ADHD in adulthood, for which atomoxetine
was introduced into treatment. Psychological
testing in the second patient established
the presence of borderline personality disorder in
exacerbation, caused by emotional overload and
high stress. Reboxetine was introduced into treatment.
Results: Following the applied treatment,
there was clinically significant improvement in
mental status. Conclusion: ADHD and borderline
personality disorder in adulthood are difficult to
differentiate clinically and may also occur as comorbid
diagnoses. A comprehensive history and
psychological testing are crucial for establishing
the correct diagnosis, which is necessary for the
appropriate choice of treatment. Targeted therapy
significantly improves long‑term outcomes.

Keywords

ADHD; borderline personality disorder; pharmacotherapy

Hrčak ID:

352327

URI

https://hrcak.srce.hr/352327

Publication date:

15.6.2026.

Article data in other languages: croatian

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