Hestbaek Emilie, Pedersen Johanna Kølle, Kjærstad Hanne Lie, Grage Kirsten Rosenkrantz, Kessing Lars Vedel, Simonsen Sebastian, Miskowiak Kamilla
Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Gentofte, Denmark; Neurocognition and Emotion in Affective Disorders (NEAD), Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Denmark.
Department of Psychology, University of Copenhagen, Copenhagen, Denmark; Neurocognition and Emotion in Affective Disorders (NEAD), Mental Health Services, Capital Region of Denmark, and Department of Psychology, University of Copenhagen, Denmark.
Eur Neuropsychopharmacol. 2025 Sep;98:13-21. doi: 10.1016/j.euroneuro.2025.06.010. Epub 2025 Jul 11.
Distinguishing borderline personality disorder (BPD) from bipolar disorder type II (BD-II) is challenging due to overlapping symptoms, often leading to misdiagnosis and suboptimal treatment. This study explored transdiagnostic and diagnostic differences in emotional cognition between patients with BPD, patients with BD-II and healthy controls (HC).
The sample included 35 patients with BPD, 35 with BD-II in remission, and 35 HC. Emotional cognition was assessed with virtual reality (VR) and the Facial Expression Recognition Task. Participants completed questionnaires regarding occupational and social functioning, quality of life, and childhood trauma. Transdiagnostic differences were explored by comparing each patient group to HC, and diagnostic differences were examined between BPD and BD-II. Regression analyses evaluated the impact of childhood trauma on emotional cognition.
Transdiagnostically, patients showed poorer emotion regulation in negative VR scenarios compared to HC, but there were no differences in emotional face processing. Differential diagnostically, patients with BPD were slower at identifying emotional faces than those with BD-II, with trends towards lower accuracy. No significant differences were observed between patients with BPD and patients with BD-II in VR scenarios. Across participants, childhood trauma predicted blunted emotion ratings and slower facial emotion recognition.
Impaired emotion regulation may serve as a transdiagnostic biomarker for BPD and BD-II, while slower emotion recognition may distinguish BPD from BD-II. Across participants, childhood trauma predicted blunted emotion ratings and slower facial emotion recognition, underscoring its lasting impact.
由于症状重叠，区分边缘型人格障碍（BPD）和II型双相情感障碍（BD-II）具有挑战性，这常常导致误诊和治疗效果不佳。本研究探讨了BPD患者、BD-II患者和健康对照者（HC）在情绪认知方面的跨诊断和诊断差异。
样本包括35名BPD患者、35名处于缓解期的BD-II患者和35名HC。使用虚拟现实（VR）和面部表情识别任务评估情绪认知。参与者完成了关于职业和社会功能、生活质量以及童年创伤的问卷调查。通过将每个患者组与HC进行比较来探索跨诊断差异，并检查BPD和BD-II之间的诊断差异。回归分析评估童年创伤对情绪认知的影响。
在跨诊断方面，与HC相比，患者在负面VR场景中的情绪调节能力较差，但在面部表情处理方面没有差异。在鉴别诊断方面，BPD患者识别情绪面孔的速度比BD-II患者慢，且准确性有降低的趋势。在VR场景中，BPD患者和BD-II患者之间未观察到显著差异。在所有参与者中，童年创伤预示着情绪评分迟钝和面部情绪识别速度较慢。
情绪调节受损可能是BPD和BD-II的跨诊断生物标志物，而情绪识别较慢可能有助于区分BPD和BD-II。在所有参与者中，童年创伤预示着情绪评分迟钝和面部情绪识别速度较慢，凸显了其持久影响。
