Gaps in knowledge about personality disorders in homeless populations (commentary for article by Whitbeck, Armenta, and Welch-Lazoritz, “Borderline personality disorder and Axis I psychiatric and substance use disorders among women experiencing homelessness in three US cities”)

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.

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Non-heterosexual identity and substance use disorders: The mediating role of borderline personality disorder features

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2014.09.218 ◽

2015 ◽

Vol 146 ◽

pp. e276-e277

Author(s):

Lauren R. Few ◽

Colleen A. Sloan ◽

Nicholas G. Martin ◽

Timothy J. Trull ◽

Arpana Agrawal ◽

...

Keyword(s):

Substance Use ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Substance Use Disorders ◽

Borderline Personality ◽

Heterosexual Identity ◽

Mediating Role

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Intensive Dialectical Behavior Treatment for Individuals With Borderline Personality Disorder With and Without Substance Use Disorders

Frontiers in Psychology ◽

10.3389/fpsyg.2021.629842 ◽

2021 ◽

Vol 12 ◽

Author(s):

Frank D. Buono ◽

Kaitlyn Larkin ◽

David Rowe ◽

M. Mercedes Perez-Rodriguez ◽

Matthew E. Sprong ◽

...

Keyword(s):

Substance Use ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Substance Use Disorders ◽

Substance Use Disorder ◽

Treatment Program ◽

Coping Skills ◽

Behavioral Therapy ◽

Borderline Personality ◽

Depression Symptom

Treatment of borderline personality disorder (BPD) with comorbid substance use disorder can be challenging due to symptom overlap and limited assessment methods. Preliminary evidence has shown promising effectiveness of dialectical behavioral therapy (DBT) for BPD with comorbid substance use disorders. The current study compared the benefits of a 28-day transitional DBT treatment program for individuals with BPD with and without substance use disorders through evaluating the changes in coping skills, generalized anxiety, and depression symptom scales at admission and discharge. A total of 76 patients were split into two groups: Group 1 consisted of individuals with BPD without substance use disorders (n = 41), and Group 2 involved individuals with BPD and a substance use disorder (SUD) (n = 35). A univariate general linear model showed significant differences between the two groups in improvement of coping skills and depressive symptoms. After a 28-day transitional DBT treatment program there were significant decreases from severe to moderate depression scores in both groups. Our findings support the effectiveness of DBT treatment in patients with comorbid BPD and SUD.

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