2204 – Differential diagnosis between bipolar disorder and borderline personality disorder based on early life stress and psychoneuroendocrine assessment

2013 ◽  
Vol 28 ◽  
pp. 1
Author(s):  
A.K. Mazer ◽  
M. Juruena
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Life Stress ◽  
Early Life ◽  
Early Life Stress ◽  
Borderline Personality

Differential Diagnosis of Borderline Personality Disorder from Bipolar Disorder

2010 ◽  
Vol 32 (3) ◽  
pp. 189-205 ◽  
Author(s):  
Gregory Hatchett
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Atypical Antipsychotics ◽  
Treatment Approach ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Health Counseling ◽  
Dsm V

Many psychiatrists have reconceptualized borderline personality disorder (BPD) as a variant of bipolar disorder and, consistent with the treatment of bipolar disorder, emphasize the use of mood stabilizers and atypical antipsychotics in treatment. This change in diagnostic practice is unfortunate. BPD is a distinct diagnostic construct, and clients who fit this pattern require a fundamentally different treatment approach than what is typically recommended for bipolar disorder. The purpose of this article is to update counselors on the expansion of bipolar disorder in the psychiatric literature, present evidence for the validity of BPD, discuss strategies for the differential diagnosis of it from bipolar disorder, review proposed changes in DSM-V, and integrate the literature into a mental health counseling framework.

scholarly journals Associations between age and cortisol awakening response in patients with borderline personality disorder

2021 ◽  
Author(s):  
Juliane Rausch ◽  
Elisa Flach ◽  
Angelika Panizza ◽  
Romuald Brunner ◽  
Sabine C. Herpertz ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Life Stress ◽  
Early Life Stress ◽  
Borderline Personality ◽  
Cortisol Awakening Response ◽  
Older Individuals ◽  
Control Factors ◽  
Specific Effects ◽  
Adolescents And Adults

AbstractPatients with borderline personality disorder (BPD) often display increased stress vulnerability, which may be linked to altered hypothalamus–pituitary–adrenal (HPA) axis functioning. Corresponding deviations of the cortisol awakening response (CAR) are presumed to mirror maladaptive neuroendocrine processes, which may explain why CARs are increased compared to healthy controls (HC). Prior research speculated that these alterations may be caused by early life stress and/or chronic stress related to the ongoing burden of the disorder. Yet, it remains to be investigated how BPD influences CAR in the course of development. Therefore, the current study examined CAR in female adolescents and adults with BPD compared to HC with a particular focus on associations with age. These potential associations were especially focused, as it was hypothesized that the CAR would be even more elevated (i.e., higher) in older individuals with BPD. CAR was assessed in 54 female individuals with BPD (aged 15–40 years) and 54 sex-, age-, and intelligence-matched HC (aged 15–48 years). Group differences were investigated and analyses of covariance using age as continuous predictor were performed to analyze potential developmental associations with CAR alongside BPD-specific effects. Pearson’s correlations were calculated to examine associations between CAR and age. Analyses were repeated with potential confounders as control factors. Results not only demonstrated increased CARs in female individuals with BPD compared to HC but demonstrated elevated CARs with increasing age in BPD individuals exclusively. Effects remained stable after controlling for potential confounders. Thereby, findings suggest that endocrine alterations in BPD may reinforce with increasing age and BPD chronicity.

Borderline Personality Disorder and Mood Disorders

2017 ◽  
Author(s):  
Eric A. Fertuck ◽  
Megan S. Chesin ◽  
Brian Johnston
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Borderline Personality Disorder ◽  
Major Depression ◽  
Personality Disorder ◽  
Mood Disorders ◽  
Suicide Risk ◽  
Borderline Personality ◽  
Mood Symptoms ◽  
Affective Instability

Borderline personality disorder (BPD) and mood disorder (MD) can be difficult to differentiate from each other due to several overlapping clinical features. Among BPD symptoms, chronic dysphoria can be mistaken for major depression, while affective instability may be confused with the depressed and elevated mood episodes of bipolar disorder (BD). Conversely, in those with BPD, co-occurring MDs can be difficult to rigorously assess and treat. Even though there is moderate to high co-occurrence between these conditions, BPD and MDs have distinct facets of impulsivity, affective instability, and mood symptoms. Furthermore, BPD, MD, and their co-occurrence predict courses of illness, prognosis, treatment outcomes, and suicide risk. Consequently, thorough assessment and differential diagnosis of these conditions should inform treatment planning and clinical management in both BPD and MD.

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