Frías Álvaro, Baltasar Itziar, Birmaher Boris
FPCEE Blanquerna, University of Ramon-Llull, Barcelona, Spain; Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Mataró, Spain; Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, United States.
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, United States.
J Affect Disord. 2016 Sep 15;202:210-9. doi: 10.1016/j.jad.2016.05.048. Epub 2016 May 30.
The relationship between bipolar disorder (BD) and borderline personality disorder (BPD) has been controversial and widely debated. Specifically, the comorbidity between both disorders has yielded a plethora of research, but there are no comprehensive reviews on this issue.
To determine the empirical evidence regarding the comorbidity between BD and BPD based on prevalence data, explanatory theories for their co-occurrence, and clinical impact of one disorder in the other.
A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between January 1985 and August 2015 were identified. Overall, 70 studies fulfilled inclusion criteria.
Over a fifth of subjects showed comorbidity between BPD and BD. Empirical evidence from common underlying factors was inconclusive, but BPD appears to be a risk factor for BD. Data also indicated that the negative impact of BPD in BD (e.g., suicidality, worse mood course) was greater than vice verse.
Given the high prevalence of comorbidity between BD and BPD and the negative effects of BPD in subjects with BD, further studies are needed to clarify the factor associated with the comorbidity between these two disorders. This information is important to develop appropriate treatments for subjects with both disorders, improve their clinical course, and prevent the increased risk of suicidality commonly found in these subjects.
双相情感障碍（BD）与边缘型人格障碍（BPD）之间的关系一直存在争议且广受讨论。具体而言，这两种障碍的共病情况引发了大量研究，但尚无关于此问题的全面综述。
基于患病率数据、二者共病的解释理论以及一种障碍对另一种障碍的临床影响，确定双相情感障碍与边缘型人格障碍共病的实证证据。
对数据库（PubMed和PsycINFO）进行全面检索。识别出1985年1月至2015年8月间发表的手稿。总体而言，70项研究符合纳入标准。
超过五分之一的受试者显示出边缘型人格障碍与双相情感障碍共病。来自共同潜在因素的实证证据尚无定论，但边缘型人格障碍似乎是双相情感障碍的一个危险因素。数据还表明，边缘型人格障碍对双相情感障碍的负面影响（如自杀倾向、更差的情绪病程）大于相反情况。
鉴于双相情感障碍与边缘型人格障碍共病的高患病率以及边缘型人格障碍对双相情感障碍患者的负面影响，需要进一步研究以阐明与这两种障碍共病相关的因素。这些信息对于为患有这两种障碍的患者制定合适的治疗方案、改善其临床病程以及预防这些患者中常见的自杀风险增加至关重要。
