Comorbid Bipolar Disorder and Borderline Personality Disorder and History of Suicide Attempts

2014 ◽  
Vol 28 (3) ◽  
pp. 358-364 ◽  
Author(s):  
Mark Zimmerman ◽  
Jennifer Martinez ◽  
Diane Young ◽  
Iwona Chelminski ◽  
Theresa A. Morgan ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
History Of

scholarly journals Psychosocial morbidity associated with bipolar disorder and borderline personality disorder in psychiatric out-patients: Comparative study

2015 ◽  
Vol 207 (4) ◽  
pp. 334-338 ◽  
Author(s):  
Mark Zimmerman ◽  
William Ellison ◽  
Theresa A. Morgan ◽  
Diane Young ◽  
Iwona Chelminski ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
College Graduates ◽  
Borderline Personality ◽  
Structured Interviews ◽  
Public Health Perspective ◽  
Repeated Calls ◽  
History Of ◽  
Psychosocial Morbidity

BackgroundThe morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders.AimsTo compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder.MethodPatients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder.ResultsThe patients with borderline personality disorder less frequently were college graduates, were diagnosed with more comorbid disorders, more frequently had a history of substance use disorder, reported more suicidal ideation at the time of the evaluation, more frequently had attempted suicide, reported poorer social functioning and were rated lower on the Global Assessment of Functioning. There was no difference between the two patient groups in history of admission to psychiatric hospital or time missed from work during the past 5 years.ConclusionsThe level of psychosocial morbidity associated with borderline personality disorder was as great as (or greater than) that experienced by patients with bipolar disorder. From a public health perspective, efforts to improve the detection and treatment of borderline personality disorder might be as important as efforts to improve the recognition and treatment of bipolar disorder.

Borderline Personality Disorder

2018 ◽  
pp. 245-270
Author(s):  
Carol S. North ◽  
Sean H. Yutzy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Borderline Personality ◽  
Historical Background ◽  
Self Mutilation ◽  
History Of ◽  
The Common ◽  
Cognitive Problems

Borderline personality disorder is a fairly recent label of a variously conceptualized phenomenon which has been characterized by affective instability and emotional crises, cognitive problems, impulsivity, and intense and unstable personal relationships. This chapter reviews the historical background, epidemiology, and clinical picture (including comorbidity) of borderline personality disorder. Although progress toward validation of this diagnosis has been made, the current definition does not appear to meet the accepted gold standard criteria for a syndrome that is currently considered valid (and reliable). The natural history of what is known is reviewed, as well as the common complications, including self-mutilation and suicide attempts. Treatment remains challenging at best, with few interventions meeting rigorous randomized controlled trial standards.

Differences between patients with borderline personality disorder who do and do not have a family history of bipolar disorder

2014 ◽  
Vol 55 (7) ◽  
pp. 1491-1497 ◽  
Author(s):  
Mark Zimmerman ◽  
Jennifer Martinez ◽  
Diane Young ◽  
Iwona Chelminski ◽  
Kristy Dalrymple
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Family History ◽  
Personality Disorder ◽  
Borderline Personality ◽  
History Of

Patients with borderline personality disorder and bipolar disorder: a descriptive and comparative study

2020 ◽  
pp. 1-12
Author(s):  
Mark Zimmerman ◽  
Caroline Balling ◽  
Iwona Chelminski ◽  
Kristy Dalrymple
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Rhode Island ◽  
Childhood Trauma ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Psychiatric Outpatients ◽  
Structured Interviews ◽  
Psychosocial Morbidity

Abstract Background Bipolar disorder and borderline personality disorder (BPD) are each significant public health problems. It has been frequently noted that distinguishing BPD from bipolar disorder is challenging. Consequently, reviews and commentaries have focused on differential diagnosis and identifying clinical features to distinguish the two disorders. While there is a burgeoning literature comparing patients with BPD and bipolar disorder, much less research has characterized patients with both disorders. In the current report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compare psychiatric outpatients with both BPD and bipolar disorder to patients with BPD without bipolar disorder and patients with bipolar disorder without BPD. Methods Psychiatric outpatients presenting for treatment were evaluated with semi-structured interviews. The focus of the current study is the 517 patients with both BPD and bipolar disorder (n = 59), BPD without bipolar disorder (n = 330), and bipolar disorder without BPD (n = 128). Results Compared to patients with bipolar disorder, the patients with bipolar disorder and BPD had more comorbid disorders, psychopathology in their first-degree relatives, childhood trauma, suicidality, hospitalizations, time unemployed, and likelihood of receiving disability payments. The added presence of bipolar disorder in patients with BPD was associated with more posttraumatic stress disorder in the patients as well as their family, more bipolar disorder and substance use disorders in their relatives, more childhood trauma, unemployment, disability, suicide attempts, and hospitalizations. Conclusions Patients with both bipolar disorder and BPD have more severe psychosocial morbidity than patients with only one of these disorders.

scholarly journals Borderline personality disorder and prior suicide attempts define a severity gradient among hospitalized adolescent suicide attempters

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aveline Aouidad ◽  
David Cohen ◽  
Bojan Mirkovic ◽  
Hugues Pellerin ◽  
Sébastien Garny de La Rivière ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Anxiety Disorders ◽  
Adolescent Suicide ◽  
Suicide Attempts ◽  
Conduct Disorders ◽  
Borderline Personality ◽  
Self Injury ◽  
History Of ◽  
Clinical Interactions

Abstract Background Borderline personality disorder (BPD) and history of prior suicide attempt (SA) have been shown to be high predictors for subsequent suicide. However, no previous study has examined how both factors interact to modify clinical and suicide severity among adolescents. Methods This study presents a comprehensive assessment of 302 adolescents (265 girls, mean age = 14.7 years) hospitalized after a SA. To test clinical interactions between BPD and history of prior SA, the sample was divided into single attempters without BPD (non-BPD-SA, N = 80), single attempters with BPD (BPD-SA, N = 127) and multiple attempters with BPD (BPD-MA, N = 95). Results Univariate analyses revealed a severity gradient among the 3 groups with an additive effect of BPD on the clinical and suicide severity already conferred by a history of SA. This gradient encompassed categorical (anxiety and conduct disorders and non-suicidal-self-injury [NSSI]) and dimensional comorbidities (substance use and depression severity) and suicide characteristics (age at first SA). According to regression analyses, the BPD-MA group that was associated with the most severe clinical presentation also showed specific features: the first SA at a younger age and a higher prevalence of non-suicidal self-injury (NSSI) and anxiety disorders. The BPD-MA group was not associated with higher impulsivity or frequency of negative life events. Conclusions Based on these findings and to improve youth suicide prevention, future studies should systematically consider BPD and the efficacy of reinforcing early interventions for anxiety disorders and NSSI.

Abuse and Neglect in Childhood: Relationship to Personality Disorder Diagnoses

CNS Spectrums ◽  
2003 ◽  
Vol 8 (10) ◽  
pp. 737-754 ◽  
Author(s):  
Linda M. Bierer ◽  
Rachel Yehuda ◽  
James Schmeidler ◽  
Vivian Mitropoulou ◽  
Antonia S. New ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Childhood Trauma ◽  
Emotional Abuse ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Antisocial Personality ◽  
Abuse And Neglect ◽  
History Of

ABSTRACTBackground:Childhood history of abuse and neglect has been associated with personality disorders and has been observed in subjects with lifetime histories of suicidality and self-injury. Most of these findings have been generated from inpatient clinical samples.Methods:This study evaluated self-rated indices of sustained childhood abuse and neglect in an outpatient sample of well-characterized personality disorder subjects (n=182) to determine the relative associations of childhood trauma indices to specific personality disorder diagnoses or clusters and to lifetime history of suicide attempts or gestures. Subjects met criteria for ~2.5 Axis II diagnoses and 24% reported past suicide attempts. The Childhood Trauma Questionnaire was administered to assess five dimensions of childhood trauma exposure (emotional, physical, and sexual abuse, and emotional and physical neglect). Logistic regression was employed to evaluate salient predictors among the trauma measures for each cluster, personality disorder, and history of attempted suicide and self-harm. All analyses controlled for gender distribution.Results:Seventy-eight percent of subjects met dichotomous criteria for some form of childhood trauma; a majority reported emotional abuse and neglect. The dichotomized criterion for global trauma severity was predictive of cluster B, borderline, and antisocial personality disorder diagnoses. Trauma scores were positively associated with cluster A, negatively with cluster C, but were not significantly associated with cluster B diagnoses. Among the specific diagnoses comprising cluster A, paranoid disorder alone was predicted by sexual, physical, and emotional abuse. Within cluster B, only antisocial personality disorder showed significant associations with trauma scores, with specific prediction by sexual and physical abuse. For borderline personality disorder, there were gender interactions for individual predictors, with emotional abuse being the only significant trauma predictor, and only in men. History of suicide gestures was associated with emotional abuse in the entire sample and in women only; self-mutilatory behavior was associated with emotional abuse in men.Conclusion:These results suggest that childhood emotional abuse and neglect are broadly represented among personality disorders, and associated with indices of clinical severity among patients with borderline personality disorder. Childhood sexual and physical abuse are highlighted as predictors of both paranoid and antisocial personality disorders. These results help qualify prior observations of the association of childhood sexual abuse with borderline personality disorder.

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