[Borderline Personality Disorder in Patients on the Autism Spectrum: Clinical and Diagnostic Implications]

This review examines the symptomatic overlap, comorbidity, and diagnostic challenges between Autism Spectrum Disorder (ASD) and Borderline Personality Disorder (BPD), particularly among women. The current literature highlights shared difficulties in social functioning, emotional regulation, and tendencies toward impulsive and self-harming behaviors in both disorders. However, there are key distinguishing symptoms: ASD is characterized by repetitive patterns, restricted interests, and unique sensory processing, while BPD is marked by fear of abandonment, unstable self-image, and feelings of emptiness. The gender context underscores the phenomenon of "camouflaging" in autistic women, which can lead to cognitive exhaustion and the misinterpretation of their symptoms as signs of BPD. Such misdiagnosis may result in ineffective or even harmful treatment. The review emphasizes the importance of accurate differential diagnosis through structured clinical interviews, self-report questionnaires, and thorough developmental assessments, with a focus on corroborating childhood difficulties via external informants. Lastly, it advocates for increased awareness of the female autism phenotype and the adoption of gender-sensitive diagnostic and therapeutic approaches to prevent misdiagnosis and improve patient quality of life.