• Source
    • "Contemporary diagnostic manuals including DSM-5 describe these disorders as distinct entities in separate sections of the manual, with clear differences in terms of prevalence, outcomes and course of illness [2,42–44]. While the existing literature regarding the course of illness of co-occurring BD and BPD is limited, clinical literature highlights the debilitating nature of this comorbidity , which may be characterized by an earlier onset, more numerous and severe mood episodes, worse interepisode functioning, reduced treatment adherence and worse outcomes with medication treatment [45] [46] [47] [48] [49] [50]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: Clinical studies suggest a high co-morbidity rate of borderline personality disorder (BPD) with bipolar disorder (BD). This study examines the prevalence and correlates of BPD in BD (I and II) in a longitudinal population-based survey. Methods: Data came from Waves 1 and 2 (Wave 2: N = 34,653, 70.2% cumulative response rate; age ≥ 20 years) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Lay interviewers conducted in person interviews using the Alcohol Use Disorders and Associated Disabilities Interview (AUDADIS-IV), a reliable diagnostic tool of psychiatric disorders based on DSM-IV criteria. Subjects with BD I (n = 812), BD I/BPD (n = 360), BD II (n = 327) and BD II/BPD (n = 101) were examined in terms of sociodemographics, mood, anxiety, substance use and personality disorder co-morbidities and history of childhood traumatic experiences. Results: Lifetime prevalence of BPD was 29.0% in BD I and 24.0% in BD II. Significant differences were observed between co-morbid BD I/II and BPD versus BD I/II without BPD in terms of number of depressive episodes and age of onset co-morbidity, and childhood trauma. BPD was strongly and positively associated with incident BD I (AOR = 16.9; 95% CI: 13.88-20.55) and BD II (AOR = 9.5; 95% CI: 6.44-13.97). Conclusions: BD with BPD has a more severe presentation of illness than BD alone. The results suggest that BPD is highly predictive of a future diagnosis of BD. Childhood traumatic experiences may have a role in understanding this relationship.
    Full-text · Article · Jan 2015 · Comprehensive psychiatry
  • Source
    • "Some studies report BPD as the most common personality disorder among adult BP patients (O'Connell et al., 1991; Peselow et al., 1995; Vieta et al., 1999). Adult BP patients with comorbid personality disorders have less favorable outcomes including longer and more frequent hospitalizations (Barbato and Hafner, 1998; Dunayevich et al., 2000), increased suicidal ideation and attempts (Carpiniello et al., 2011; Vieta et al., 1999), greater symptom severity and functional impairment (Barbato and Hafner, 1998; Carpenter et al., 1995; George et al., 2003), earlier age of mood symptom onset (Vieta et al., 1999), greater unemployment (Kay et al., 2002), higher rates of axis I comorbidity (Kay et al., 2002; Preston et al., 2004), and worsened long-term outcomes of symptomatic and functional recovery (Bieling et al., 2003; Dunayevich et al., 2000) compared to those without personality disorders. This comorbidity has been further associated with poor pharmacotherapy outcomes as evidenced by reduced compliance (Colom et al., 2000) and response to treatment (Barbato and Hafner, 1998), and necessity for polypharmacy (Kay et al., 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Little is known regarding correlates of borderline personality-spectrum symptoms (BPSS) among adolescents with bipolar disorder (BP). Methods Participants were 90 adolescents, 13–19 years of age, who fulfilled DSM-IV-TR criteria for BP using semi-structured diagnostic interviews. BPSS status was ascertained using the Life Problems Inventory which assessed identity confusion, interpersonal problems, impulsivity, and emotional lability. Analyses compared adolescents with “high” versus “low” BPSS based on a median split. Results Participants with high, relative to low, BPSS were younger, and had greater current and past depressive episode severity, greater current hypo/manic episode severity, younger age of depression onset, and reduced global functioning. High BPSS participants were more likely to have BP-II, and had higher rates of social phobia, generalized anxiety disorder, conduct disorder, oppositional defiant disorder, homicidal ideation, assault of others, non-suicidal self-injury, suicidal ideation, and physical abuse. Despite greater illness burden, high BPSS participants reported lower rates of lithium use. The most robust independent predictors of high BPSS, identified in multivariate analyses, included lifetime social phobia, non-suicidal self-injury, reduced global functioning, and conduct and/or oppositional defiant disorder. Limitations The study design is cross-sectional and cannot determine causality. Conclusions High BPSS were associated with greater mood symptom burden and functional impairment. Presence of high BPSS among BP adolescents may suggest the need to modify clinical monitoring and treatment practices. Future prospective studies are needed to examine the direction of observed associations, the effect of treatment on BPSS, and the effect of BPSS as a moderator or predictor of treatment response.
    Full-text · Article · Jan 2015
  • Source
    • "Some studies report BPD as the most common personality disorder among adult BP patients (O'Connell et al., 1991; Peselow et al., 1995; Vieta et al., 1999). Adult BP patients with comorbid personality disorders have less favorable outcomes including longer and more frequent hospitalizations (Barbato and Hafner, 1998; Dunayevich et al., 2000), increased suicidal ideation and attempts (Carpiniello et al., 2011; Vieta et al., 1999), greater symptom severity and functional impairment (Barbato and Hafner, 1998; Carpenter et al., 1995; George et al., 2003), earlier age of mood symptom onset (Vieta et al., 1999), greater unemployment (Kay et al., 2002), higher rates of axis I comorbidity (Kay et al., 2002; Preston et al., 2004), and worsened long-term outcomes of symptomatic and functional recovery (Bieling et al., 2003; Dunayevich et al., 2000) compared to those without personality disorders. This comorbidity has been further associated with poor pharmacotherapy outcomes as evidenced by reduced compliance (Colom et al., 2000) and response to treatment (Barbato and Hafner, 1998), and necessity for polypharmacy (Kay et al., 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Results: Participants with high, relative to low, BPSS were younger, and had greater current and past depressive episode severity, greater current hypo/manic episode severity, younger age of depression onset, and reduced global functioning. High BPSS participants were more likely to have BP-II, and had higher rates of social phobia, generalized anxiety disorder, conduct disorder, oppositional defiant disorder, homicidal ideation, assault of others, non-suicidal self-injury, suicidal ideation, and physical abuse. Despite greater illness burden, high BPSS participants reported lower rates of lithium use. The most robust independent predictors of high BPSS, identified in multivariate analyses, included lifetime social phobia, non-suicidal self-injury, reduced global functioning, and conduct and/or oppositional defiant disorder.
    Full-text · Article · Sep 2014 · Journal of Affective Disorders
Show more