scholarly journals Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals

Medicina ◽  
2019 ◽  
Vol 55 (1) ◽  
pp. 13 ◽  
Author(s):  
Rikinkumar S. Patel ◽  
Geetha Manikkara ◽  
Amit Chopra
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Risk ◽  
Borderline Personality ◽  
Inpatient Setting ◽  
Inpatient Outcomes ◽  
Increased Risk ◽  
Bipolar Patients ◽  
The Impact

Background and objectives: The quality of life and disease outcomes in bipolar patients, including increased risk of psychiatric hospitalizations and suicide, are adversely affected by the presence of borderline personality disorder (BPD). Our study aims to determine the impact of BPD on the inpatient outcomes of bipolar disorder patients. Methods: We used Nationwide Inpatient Sample from the US hospitals and identified cases with bipolar disorder and comorbid BPD (N = 268,232) and controls with bipolar disorder only (N = 242,379), using the International Classification of Diseases, 9th Revision, and Clinical Modification codes. We used multinomial logistic regression to generate odds ratios (OR) and evaluate inpatient outcomes. Results: The majority of the bipolar patients with BPD were female (84.2%), Caucasian (83.1%) and 18–35 years age (53.9%). Significantly longer inpatient stays, higher inpatient charges, and higher prevalence of drug abuse were noted in bipolar patients with BPD. The suicide risk was higher in bipolar patients with BPD (OR = 1.418; 95% CI 1.384–1.454; p <0.001). In addition, utilization of electroconvulsive treatment (ECT) was higher in bipolar patients with comorbid BPD (OR = 1.442; 95% CI 1.373–1.515; p <0.001). Conclusions: The presence of comorbid BPD in bipolar disorder is associated with higher acute inpatient care due to a longer inpatient stay and higher cost during hospitalization, and higher suicide risk, and utilization of ECT. Further studies in the inpatient setting are warranted to develop effective clinical strategies for optimal outcomes and reduction of suicide risk in bipolar patients with BPD.

scholarly journals The relationship between borderline personality disorder and bipolar disorder

2013 ◽  
Vol 15 (2) ◽  
pp. 155-169 ◽  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Bipolar Spectrum ◽  
Bipolar Ii ◽  
Axis I ◽  
Bipolar Patients ◽  
The Relationship

It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We reviewed the most studied question on the relationship between BPD and bipolar disorder: their diagnostic concordance. Across studies, approximately 10% of patients with BPD had bipolar I disorder and another 10% had bipolar II disorder. Likewise, approximately 20% of bipolar II patients were diagnosed with BPD, though only 10% of bipolar I patients were diagnosed with BPD. While the comorbidity rates are substantial, each disorder is nontheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%). In studies examining personality disorders broadly, other personality disorders were more commonly diagnosed in bipolar patients than was BPD. Likewise, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are also more commonly diagnosed in patients with BPD than is bipolar disorder. These findings challenge the notion that BPD is part of the bipolar spectrum.

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.

scholarly journals Heart rate variability in bipolar disorder and borderline personality disorder: a clinical review

2017 ◽  
Vol 21 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Oliver Carr ◽  
Maarten de Vos ◽  
Kate E A Saunders
Keyword(s):  
Bipolar Disorder ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychiatric Disorders ◽  
Borderline Personality ◽  
Ongoing Research ◽  
Area Of Interest ◽  
Technological Advances

Heart rate variability (HRV) in psychiatric disorders has become an increasing area of interest in recent years following technological advances that enable non-invasive monitoring of autonomic nervous system regulation. However, the clinical interpretation of HRV features remain widely debated or unknown. Standardisation within studies of HRV in psychiatric disorders is poor, making it difficult to reproduce or build on previous work. Recently, a Guidelines for Reporting Articles on Psychiatry and Heart rate variability checklist has been proposed to address this issue. Here we assess studies of HRV in bipolar disorder and borderline personality disorder against this checklist and discuss the implication for ongoing research in this area.

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