"Borderpath" for Cluster B Personality Disorder?

To the Editor: Over the years there has been much debate over the nosological status and nomenclature of personality disorders (1). Factor and cluster analytic approaches have indicated three or four major groups (2), and DSM-IV uses a three-cluster system. The fourth group, which is characterized by abnormally rigidity and fastidiousness, has been grouped with cluster C.

In clinical practice, we often see patients with combined borderline and antisocial traits for whom DSM-IV and ICD-10 do not provide clear-cut categories. The term "psychopath," even though it has clinical descriptive value, is not an easy term to explain to a patient and is a misleading description of the complex mixture of personality traits that are evident in this patient group. The term "cluster B personality disorder" is rather unwieldy, and our nonpsychiatrist colleagues may not know what the term means without having to look it up. We suggest the term "borderpath," a fusion of borderline and psychopath, which describes a clinical entity and is relatively self-descriptive.

Dr. Swift is associate specialist in psychiatry at Shelton Hospital in Shrewsbury, United Kingdom. Dr. Nandhra is specialist registrar in psychiatry in the John Hampden unit of Stoke Mandeville Hospital in Aylesbury, Buckinghamshire, United Kingdom.