BPD sometimes lives in ‘shadow’ of bipolar disorder

Borderline personality disorder is associated with levels of psychosocial morbidities that rival and sometimes surpass those found in bipolar disorder, according to Dr. Mark Zimmerman and his associates.

The investigators assessed patients with borderline personality disorder and bipolar disorder using semistructured interviews. Nearly 80% of the borderline personality patients (BPD) had three or more Axis I disorders, compared with 34% of bipolar patients. Patients with borderline personality disorders were more likely to have Global Assessment of Functioning scores of 50 or less. BPD patients also were less likely to have graduated from college and to be married, compared with their bipolar counterparts.

Despite those findings, about 51% of bipolar patients reported admission to a psychiatric hospital, compared with 43% of BPD patients.

“A potential consequence of the campaign to improve the recognition of bipolar disorder has been its overdiagnosis (and overtreatment) in patients with borderline personality disorder. The overdiagnosis of bipolar disorder to the neglect of borderline personality disorder might become an even greater problem in the future if efforts to expand bipolar disorder’s diagnostic boundary take hold,” noted Dr. Zimmerman of the department of psychiatry and human behavior at Brown University in Providence, R.I., and his associates.

Find the full study in the British Journal of Psychiatry (2015 [doi:10.1192/bjp.bp.114.153569]).

Borderline personality disorder is associated with levels of psychosocial morbidities that rival and sometimes surpass those found in bipolar disorder, according to Dr. Mark Zimmerman and his associates.

The investigators assessed patients with borderline personality disorder and bipolar disorder using semistructured interviews. Nearly 80% of the borderline personality patients (BPD) had three or more Axis I disorders, compared with 34% of bipolar patients. Patients with borderline personality disorders were more likely to have Global Assessment of Functioning scores of 50 or less. BPD patients also were less likely to have graduated from college and to be married, compared with their bipolar counterparts.

Despite those findings, about 51% of bipolar patients reported admission to a psychiatric hospital, compared with 43% of BPD patients.

“A potential consequence of the campaign to improve the recognition of bipolar disorder has been its overdiagnosis (and overtreatment) in patients with borderline personality disorder. The overdiagnosis of bipolar disorder to the neglect of borderline personality disorder might become an even greater problem in the future if efforts to expand bipolar disorder’s diagnostic boundary take hold,” noted Dr. Zimmerman of the department of psychiatry and human behavior at Brown University in Providence, R.I., and his associates.

Find the full study in the British Journal of Psychiatry (2015 [doi:10.1192/bjp.bp.114.153569]).

Borderline personality disorder is associated with levels of psychosocial morbidities that rival and sometimes surpass those found in bipolar disorder, according to Dr. Mark Zimmerman and his associates.

The investigators assessed patients with borderline personality disorder and bipolar disorder using semistructured interviews. Nearly 80% of the borderline personality patients (BPD) had three or more Axis I disorders, compared with 34% of bipolar patients. Patients with borderline personality disorders were more likely to have Global Assessment of Functioning scores of 50 or less. BPD patients also were less likely to have graduated from college and to be married, compared with their bipolar counterparts.

Despite those findings, about 51% of bipolar patients reported admission to a psychiatric hospital, compared with 43% of BPD patients.

“A potential consequence of the campaign to improve the recognition of bipolar disorder has been its overdiagnosis (and overtreatment) in patients with borderline personality disorder. The overdiagnosis of bipolar disorder to the neglect of borderline personality disorder might become an even greater problem in the future if efforts to expand bipolar disorder’s diagnostic boundary take hold,” noted Dr. Zimmerman of the department of psychiatry and human behavior at Brown University in Providence, R.I., and his associates.

Find the full study in the British Journal of Psychiatry (2015 [doi:10.1192/bjp.bp.114.153569]).