Riemann Georg, Weisscher Nadine, Post Robert M, Altshuler Lori, McElroy Susan, Frye Marc A, Keck Paul E, Leverich Gabriele S, Suppes Trisha, Grunze Heinz, Nolen Willem A, Kupka Ralph W
Saxion, University of Applied Science, Handelskade 75, 7417 DH, Deventer, The Netherlands.
Dimence Mental Health, Center for Bipolar Disorders, Deventer, The Netherlands.
Int J Bipolar Disord. 2017 Sep 25;5(1):31. doi: 10.1186/s40345-017-0100-x.
Although bipolar disorder (BD) and borderline personality disorder (BPD) share clinical characteristics and frequently co-occur, their interrelationship is controversial. Especially, the differentiation of rapid cycling BD and BPD can be troublesome. This study investigates the relationship between borderline personality features (BPF) and prospective illness course in patients with BD, and explores the effects of current mood state on self-reported BPF profiles.
The study included 375 patients who participated in the former Stanley Foundation Bipolar Network. All patients met DSM-IV criteria for bipolar-I disorder (n = 294), bipolar-II disorder (n = 72) or bipolar disorder NOS (n = 9). BPF were assessed with the self-rated Personality Diagnostic Questionnaire. Illness course was based on 1-year clinician rated prospective daily mood ratings with the life chart methodology. Regression analyses were used to estimate the relationships among these variables.
Although correlations were weak, results showed that having more BPF at baseline is associated with a higher episode frequency during subsequent 1-year follow-up. Of the nine BPF, affective instability, impulsivity, and self-mutilation/suicidality showed a relationship to full-duration as well as brief episode frequency. In contrast all other BPF were not related to episode frequency.
Having more BPF was associated with an unfavorable illness course of BD. Affective instability, impulsivity, and self-mutilation/suicidality are associated with both rapid cycling BD and BPD. Still, many core features of BPD show no relationship to rapid cycling BD and can help in the differential diagnosis.
尽管双相情感障碍（BD）和边缘型人格障碍（BPD）具有共同的临床特征且常同时出现，但其相互关系仍存在争议。特别是，快速循环型双相情感障碍与边缘型人格障碍的鉴别可能会很棘手。本研究调查了双相情感障碍患者的边缘型人格特征（BPF）与疾病前瞻性病程之间的关系，并探讨了当前情绪状态对自我报告的BPF概况的影响。
该研究纳入了375名曾参与前斯坦利基金会双相情感障碍网络研究的患者。所有患者均符合双相I型障碍（n = 294）、双相II型障碍（n = 72）或未特定的双相情感障碍（n = 9）的DSM-IV标准。使用自评人格诊断问卷评估BPF。疾病病程基于采用生活图表法进行的为期1年的临床医生前瞻性每日情绪评分。采用回归分析来估计这些变量之间的关系。
尽管相关性较弱，但结果显示基线时BPF较多与随后1年随访期间的发作频率较高相关。在9种BPF中，情感不稳定、冲动性以及自我伤害/自杀倾向与全程发作以及短暂发作频率均有关系。相比之下，所有其他BPF与发作频率均无关联。
BPF较多与双相情感障碍的不良病程相关。情感不稳定、冲动性以及自我伤害/自杀倾向与快速循环型双相情感障碍和边缘型人格障碍均相关。然而，边缘型人格障碍的许多核心特征与快速循环型双相情感障碍并无关系，可有助于鉴别诊断。
