Acute Psychological Distress and Metabolic Findings in a Young Adult with Emotionally Unstable Personality Disorder: A Case Report

We present the case of a 20-year-old female, Ms. S.P.T., with a known diagnosis of Emotionally Unstable
Personality Disorder (EUPD), who was admitted to the inpatient psychiatric unit with acute-on-chronic
psychological distress. Her presentation was precipitated by a complex psychosocial crisis involving a recent
elopement, marriage to a man with a significant family history of substance abuse, and subsequent marital discord,
including alleged abuse. An initial inpatient assessment revealed a patient in significant distress. Routine
laboratory investigations were conducted to rule out organic causes for her presentation and to establish a baseline
for management. The results revealed notable metabolic abnormalities, including Vitamin B12 deficiency (160.6
pg/mL) and Vitamin D insufficiency (23 ng/mL), alongside a lipid profile with elevated LDL cholesterol (147
mg/dL) and low HDL cholesterol (39 mg/dL). Her thyroid function and other routine parameters were within
normal limits. This case highlights the critical importance of comprehensive metabolic screening in young
psychiatric inpatients. It underscores that while the primary presentation is often psychosocial, underlying
physiological abnormalities are common and can significantly impact both physical and mental health outcomes.
The case advocates for integrated care models in psychiatry that address both psychological and biological factors
from the point of admission.