Parker Gordon, Bayes Adam, Spoelma Michael J
Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
J Psychiatr Res. 2022 Jun;150:214-218. doi: 10.1016/j.jpsychires.2022.03.051. Epub 2022 Apr 4.
The prevalence of comorbid bipolar disorder (BD) and borderline personality disorder (BPD) is distinctly higher in community samples than would be expected if the two conditions are independent. While there have been multiple explanations suggested for their interdependence, no clear model has been established. This paper reviews a broader set of explanations than considered previously, where relevant prevalence studies of the conditions are reported, previous explanations overviewed, and additional potential linkage causes are considered. It was found that there is unlikely to be any single determinant of the comorbid presence of BD and BPD. The most likely candidates are the artefactual impact of transdiagnostic features, with true comorbid status reflecting both pleiotropic genetic influences and environmental factors. Measurement errors in diagnostic assignment emerging from transdiagnostic features are likely to have clouded previous studies and therefore the interpretations. Comorbid BD/BPD is likely to be distinctly more common than estimated by clinicians, and clarification of the reasons why this is may well assist clinical management.
在社区样本中，双相情感障碍（BD）与边缘型人格障碍（BPD）共病的发生率明显高于两种疾病相互独立时的预期。虽然针对它们的相互依存关系提出了多种解释，但尚未建立明确的模型。本文回顾了比以往更广泛的一系列解释，报告了相关疾病的患病率研究，概述了以往的解释，并考虑了其他潜在的关联原因。研究发现，BD和BPD共病不太可能存在单一的决定因素。最有可能的因素是跨诊断特征的人为影响，真正的共病状态反映了多效性遗传影响和环境因素。跨诊断特征导致的诊断分配测量误差可能使以往的研究及相关解释变得模糊不清。BD/BPD共病可能比临床医生估计的更为常见，阐明其原因可能有助于临床管理。
