Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA.
J Affect Disord. 2013 Jun;148(2-3):384-90. doi: 10.1016/j.jad.2012.06.027. Epub 2012 Jul 24.
Interactions between characteristics of bipolar and Axis II cluster B disorders are clinically and diagnostically challenging. Characteristics associated with personality disorders may be dimensional aspects of bipolar disorder. We investigated relationships among antisocial personality disorder (ASPD) or borderline personality disorder symptoms, impulsivity, and course of illness in bipolar disorder.
Subjects with bipolar disorder were recruited from the community. Diagnosis was by structured clinical interview for DSM-IV (SCID-I and -II), psychiatric symptom assessment by the change version of the schedule for affective disorders and schizophrenia (SADS-C), severity of Axis II symptoms by ASPD and borderline personality disorder SCID-II symptoms, and impulsivity by the Barratt impulsiveness scale (BIS-11).
ASPD and borderline symptoms were not related to clinical state or affective symptoms. Borderline symptoms correlated with BIS-11 impulsivity scores, and predicted history of suicide attempts independently of the relationship to impulsivity. ASPD symptoms were more strongly related to course of illness, including early onset, frequent episodes, and substance-related disorders. These effects persisted after allowance for gender and substance-use disorder history.
Personality disorder symptoms appear to be dimensional, trait-like characteristics of bipolar disorder. ASPD and Borderline symptoms are differentially related to impulsivity and course of illness.
双相情感障碍和轴 II 聚类 B 障碍的特征之间的相互作用在临床上和诊断上都具有挑战性。人格障碍的特征可能是双相情感障碍的维度方面。我们研究了双相情感障碍中反社会人格障碍（ASPD）或边缘型人格障碍症状、冲动性和病程之间的关系。
从社区招募双相情感障碍患者。通过 DSM-IV 的结构临床访谈（SCID-I 和 -II）进行诊断，通过情感障碍和精神分裂症的变化时间表（SADS-C）进行精神病症状评估，通过 ASPD 和边缘型人格障碍 SCID-II 症状评估轴 II 症状的严重程度，通过巴雷特冲动量表（BIS-11）评估冲动性。
ASPD 和边缘症状与临床状态或情感症状无关。边缘症状与 BIS-11 冲动性评分相关，并且独立于冲动性与自杀企图史相关，预测自杀企图史。ASPD 症状与病程的关系更为密切，包括发病早、发作频繁和与物质有关的障碍。在允许性别和物质使用障碍史的情况下，这些影响仍然存在。
人格障碍症状似乎是双相情感障碍的维度、特质样特征。ASPD 和边缘症状与冲动性和病程的关系不同。
