Mentalizing, recognized as the capacity to understand behaviors in the context of our own mental states and those of other people, is being researched more and more commonly in regard to various mental disorders. The research on mentalization focuses on, among other things, borderline personality disorder, which is at present perceived as an emerging problem in the population of adolescents. In order to summarize the currently accessible knowledge of mentalizing in adolescents with borderline personality disorder, we thoroughly analyzed relevant publications. Based on the available literature, it can be concluded that the mentalizing ability of adolescents with borderline personality disorder can be impaired. The evidence demonstrates that they are prone to hypermentalizing, defined as an overattribution of mental states to other people. However, this tendency has not been proven to be specific to teenagers with this disorder. Moreover, the existing data suggest that young people with borderline personality exhibit a reduced capacity to mentalize their own inner states.

Borderline personality disorder constitutes a significant medical challenge. Despite the fact that its occurrence among adolescents is currently attracting increasing interest from both clinicians and researchers, there is still insufficient data on this phenomenon. The etiology and maintenance of borderline personality disorder are not yet fully comprehended. Neuropeptides, including oxytocin and vasopressin, are considered to be involved in the development of this condition. The mechanism behind the actions of these neurohormones requires further investigation. Our work aims to collect and analyze the available research and existing hypotheses on the role of oxytocin and vasopressin in people with borderline personality disorder, with special attention drawn to adolescents suffering from this condition.

Background/Objectives: Adolescents admitted for emergency psychiatric hospitalization frequently present with severe and heterogeneous psychopathology. In clinical practice, some adolescent inpatients appear to present a broader symptom pattern suggestive of emotional dysregulation. However, it remains unclear whether they can truly be distinguished in this population and whether they differ meaningfully from adolescents with predominantly depressive presentations. Methods: We conducted a retrospective cross-sectional chart review with subgroup analysis based on the medical records of patients aged 11–17 years hospitalized on an emergency basis at the Department of Child and Adolescent Psychiatry in Poznań, Poland, between January and December 2024. Patients were assigned either to an emotional dysregulation group, defined by affective dysregulation and behavioral dyscontrol, or to a depressive presentations group, comprising adolescents with depressive presentations who did not meet criteria for the emotional dysregulation profile. Broader clinical characteristics, adverse childhood experiences, and prior treatment history were compared between groups. Results: A total of 139 adolescents were included (85 in the emotional dysregulation group and 54 in the depressive presentations group). The median age was 13 years [Q1–Q3: 13–14] in the emotional dysregulation group and 14 years [Q1–Q3: 12.25–14] in the depressive presentations group; girls comprised 77.6% and 83.3% of the groups, respectively. The emotional dysregulation group more often presented with conflict-ridden relationships, a more frequent history of suicide attempts (72.9% vs. 50.0%, p = 0.006), and a higher number of suicide attempts (median 1 [Q1–Q3: 0–2] vs. 0.5 [Q1–Q3: 0–1], p = 0.012), as well as more frequent exposure to adversity-related experiences. Furthermore, this group had a higher number of previous psychiatric hospitalizations (median 1 [Q1–Q3: 1–2] vs. 1 [Q1–Q3: 1–1], p = 0.001) and a longer history of psychiatric treatment. In contrast, social withdrawal was more characteristic of the depressive presentations group. Conclusions: Routinely collected clinical records may capture a clinically meaningful subgroup of adolescents with a symptom profile suggestive of emotional dysregulation. Compared with the depressive presentations group, these adolescents showed greater interpersonal difficulties, more recurrent suicide attempts, greater adversity burden, and a longer history of psychiatric treatment. Further prospective studies using standardized measures are needed.