Multiple complex developmental disorder: The "multiple and complex" evolution of the "childhood borderline syndrome" construct

Objectives: To provide an overview of the history, evolution, and nosology of the diagnostic constructs for "borderline syndrome of childhood," also k nown as "multiple complex developmental disorder." Method: The authors synt hesized information found via electronic searches of databases (MEDLINE, Ps yclNFO, Current Contents Humanities Abstracts, and Social Sciences Abstract s) and bibliographic directed searches. Results: Although early publication s (prior to 1980) were either highly anecdotal or lacking in scientific rig or, they were nonetheless noted for their historic value and influence on r esearch trends. The recent publications (1990s) were characterized by more rigorous methodology and greater generalizability. Current classifications, proposals for diagnostic criteria, epidemiological data, and nosological s uggestions were summarized. Conclusion: The literature supports the creatio n of a new diagnostic label to describe a population of children whose symp toms are currently subsumed under the labels "borderline" or "multiple comp lex developmental disorder." A full characterization of the syndrome, inclu ding its evolution, would require prospective studies and may differ from t he known evolution for personality disorders and/or pervasive developmental disorders. The authors propose a process by which a new nomenclature is de rived.