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That name that no one dares to say

Have I heard of the Voldermort diagnosis? Haven't you? Lucky you! But I will tell you a little about him. And even though it's a name that no one, or very few, dare say, I'll take my chances. And I'm not worried about spoilers. She some things you might as well know first, I assure you.

Now then, the Voldermort diagnosis is also known as Borderline Personality Disorder. So you've heard of it? Do you really? What if I told you that this disorder is in children or young people? Do you now understand the choice of the name Voldermort?

A mental health diagnosis is sometimes seen as something that can threaten young people's identity or sense of self, and professionals within child mental health do not always agree on the use of these diagnoses in their clinical practice.

More recently, research findings have been presented that an initial diagnosis of Personality Disorder in children in young people can lead to stigmatisation and avoidance of healthcare, with adverse effects in adolescence. The desire to protect young people from stigma is likely to be the main reason why clinicians worldwide continue to refrain from diagnosing a Personality Disorder in children and young people.

There are clinicians who point out that the concept of Personality Disorder is as reliable and valid in adolescence as in adults and shows comparable stability across different ages. And there has also been a greater interest among clinicians in alternative frameworks and explanations for mood instability situations and what could be seen as the interferences of a diagnosis of Borderline Personality Disorder, for example. Or there are also those who point out that the more recent alternative presented in the ICD-11 diagnosis of complex PTSD, although useful, does not adequately consider internalised behaviours or experiences that seem to be better explained by Personality Disorders, and that in addition, these two impossible conditions cannot co-exist.

And furthermore, it is now time and in a universal way to agree that personality problems are not only noticed at the age of 18, but at a much earlier age. However, we are still far from greater agreement that Personality Disorder can be identified earlier, and the arbitrarily placed age limit for diagnosis was 18.

Either because there is a lack of knowledge to help explain the child's functioning profile, and many times expert opinion overrides rationality. Or else, the fear of stigma prevails. What is certain is that many children and young people end up being deprived of an adequate intervention. And that many of the times these situations, knowing that they are better framed and explained by Personality Disorders, will tend to persist in time, and in this case mainly because of the absence of a capable clinical answer.

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