School of Medicine, University of Notre Dame, Fremantle Australia.
Aust N Z J Psychiatry. 2012 Apr;46(4):327-39. doi: 10.1177/0004867411435289. Epub 2012 Jan 11.
Bipolar affective disorder and borderline personality disorder have long been considered to have significant similarities and comorbidity. This review endeavours to clarify the similarities and differences between these disorders, with an effort to determine whether they reflect different forms of the same illness or separate illness clusters.
The published literature relating to bipolar affective disorders, borderline personality disorders, and related areas of knowledge was reviewed using searches of several electronic databases (AMED, CINHAL, Embase, Ovid, ProQuest, MEDLINE, Web of Science, ScienceDirect) and published texts. These findings were combined with the personal clinical experience of the author, and information gathered from colleagues, to create a review of this topic.
Bipolar affective disorders and borderline personality disorders differ with respect to sense of self, disruption of relationships, family history of bipolar disorders, the benefits of medications, the extent of cognitive deficits, the form of affective dysregulation and mood cycling, the incidence of suicide and suicide attempts, the form of psychotic episodes, the incidence of early sexual abuse but not early trauma in general, the loss of brain substance, alterations in cortical activity, glucocorticoid receptor sensitivity, and mitochondrial dysfunction. They are similar with respect to non-specific features of affective dysregulation, the incidence of atypical depressive features, the incidence of self-mutilation, the incidence of transporter polymorphisms, possible genetic linkages, overall reduction in limbic modulation, reduction in the size of hippocampi and amygdala, and the incidence of sleep disruption.
This review concludes that bipolar affective disorders and borderline personality disorder are separate disorders, but have significant elements in common.
双相情感障碍和边缘型人格障碍长期以来被认为具有显著的相似性和共病性。本综述旨在厘清这两种疾病之间的异同，以确定它们是否反映了同一种疾病的不同表现形式，还是不同的疾病簇。
通过对几个电子数据库（AMED、CINHAL、Embase、Ovid、ProQuest、MEDLINE、Web of Science、ScienceDirect）和已发表文献的检索，以及对作者个人的临床经验和从同事那里收集的信息进行综合分析，对双相情感障碍、边缘型人格障碍及相关知识领域的文献进行了综述。
双相情感障碍和边缘型人格障碍在自我意识、人际关系破裂、双相情感障碍家族史、药物治疗效果、认知缺陷程度、情感失调和情绪循环形式、自杀和自杀未遂发生率、精神病发作形式、性虐待发生率（但不限于一般早期创伤）、脑物质损失、皮质活动改变、糖皮质激素受体敏感性和线粒体功能障碍等方面存在差异。在情感失调的非特异性特征、非典型抑郁特征的发生率、自伤发生率、转运体多态性的发生率、可能的遗传关联、边缘系统调节的总体减少、海马体和杏仁核体积的减少以及睡眠障碍的发生率等方面存在相似性。
本综述认为，双相情感障碍和边缘型人格障碍是两种不同的疾病，但有显著的共同特征。
