RELATIONSHIP BETWEEN BORDERLINE PERSONALITY DISORDER AND BIPOLAR DISORDER

RELATIONSHIP BETWEEN BORDERLINE PERSONALITY DISORDER AND BIPOLAR DISORDER, LONG-TERM STUDY
Main Category: Bipolar
Also Included in: Depression, Psychology/Psychiatry; Mental Health
Results from a long-term study indicates that borderline personality disorder (BPD) and bipolar disorder do not commonly coexist, a finding which has important implications for treatment. The findings are reported in the July 2006 issue of The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association (APA).
BPD is a long-term, pervasive pattern of impulsive behavior, instability and changeable mood. Wheter it is a variant of bipolar disorder is the focus of the AJP article, “Descriptive and Longitudinal Observations of the Relationship of Borderline Personality Disorder and Bipolar Disorde” by John G. Gunderson. M.D., medical director for the Borderlline Personality Disorder Treatment Center at McLean Hospital.
The study found only modest connections to bipolar disorder among 196 patients with BPD. The rate ofco-occuring bipolar disoder in these patients was 19 percent. In patients with other personality disorders, the rate was eight percent. Among the patients who did not have bipolar disorder at the beginning of the study, eight percent of the BPD patients developed bipolar disorder over the next four years, compared to three percent of the patients with other personality disorders.
Despite these differences, the rates of bipolar disorder in the BPD patients remained under 20 percent. This low frequency has important implications for treatment, as many BPD patients receive only a diagnosis of bipolar disorder is the subject of intensive neurobiological research and psychopharmacological treatment,” stated Robert Freedman, M.D.AJP editor-in-chief. “This study is an important step in examining the extent of overlap between the two disorders.”
The co-occurrence of bipolar disorder did not worsen the course of BPD over four years. Remission occurred in two-thirds of both the BPD patients with and without bipolar disorder.
In an accompaning editorial, Michael H. Stone, M.D., of Columbia University notes the article's “more balanced position on the controversy” about the relationship of borderline personality to bipolar disorder. He suggests the the moderately higher rates of bipolar disorder in patients with PBD disorder may indicated a subgroup of BPD patients with higher genetic risk for bipolar disorder.
This study was funded by the National Institute of Mental Health.
About the American Journal of Psychiatry
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