Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal; CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal.
Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal; CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal.
J Affect Disord. 2021 Nov 1;294:897-907. doi: 10.1016/j.jad.2021.07.047. Epub 2021 Jul 22.
State-of-the-art research highlights that borderline personality disorder (PD) and bipolar spectrum disorders have clinical characteristics in common, which imply uncertainty in differential diagnoses. Although there is a growing body of literature on the DSM-5 dimensional model of personality disorder, its discriminative features between these clinical samples are still understudied. In this study, we seek to identify the best set of predictors that differentiate between borderline PD and bipolar spectrum, based on pathological and normative personality traits and symptoms.
A cross-sectional study of three clinical samples: 1) Borderline PD group of 63 participants; 2) Major depressive disorder group of 89 participants; 3) Bipolar disorder group of 65 participants. Self-reported assessment: Personality Inventory for DSM-5; Brief Symptom Inventory; FFM Inventory. A series of one-way ANOVAs and logistic regression analyses were computed.
The major set of data emerging as common discriminants of borderline PD across the bipolar spectrum are unusual beliefs & experiences, paranoid ideation, obsession-compulsion and extraversion. Depressivity (OR: 34.95) and impulsivity (OR: 22.35) pathological traits displayed the greatest predictive values in the differential diagnosis.
The small size of the samples; a lack of data from participants' previous clinical history.
Findings support the DSM-5 pathological traits as differentiating borderline PD through bipolar spectrum, and reinforcing the joint use of symptom-related pathological functioning and normal-range personality traits. Alongside the bipolar spectrum, borderline pathology sheds light upon a hypothetical overlap along the depressive and schizoaffective/schizophrenia spectra, representing a borderland space at a crossroads with the psychopathology of a meta-spectrum.
最先进的研究强调，边缘型人格障碍（PD）和双相谱系障碍具有共同的临床特征，这意味着在鉴别诊断中存在不确定性。尽管关于 DSM-5 人格障碍维度模型的文献越来越多，但这些临床样本之间的区分特征仍研究不足。在这项研究中，我们试图根据病理性和正常人格特质和症状，确定区分边缘型 PD 和双相谱系的最佳预测因子集。
对三个临床样本进行横断面研究：1）63 名边缘型 PD 组；2）89 名重性抑郁障碍组；3）65 名双相障碍组。自我报告评估：DSM-5 人格量表；简明症状量表；FFM 量表。进行了一系列单因素方差分析和逻辑回归分析。
作为贯穿整个双相谱系的边缘型 PD 的共同鉴别特征的主要数据集是不寻常的信念和体验、偏执观念、强迫观念和外向性。病理性特质中的抑郁（OR：34.95）和冲动性（OR：22.35）显示出最大的鉴别诊断预测值。
样本量小；缺乏参与者既往临床病史的数据。
研究结果支持 DSM-5 病理性特质通过双相谱系来区分边缘型 PD，并强化了症状相关病理性功能和正常范围人格特质的联合使用。除了双相谱系外，边缘型病理学还揭示了在抑郁和精神分裂症/精神分裂症谱系之间的假设重叠，代表了与元谱系精神病学交界的十字路口的边缘空间。
