Descriptive and longitudinal observations on the relationship of borderline personality disorder and bipolar disorder.
OBJECTIVE
The purpose of this study was to test whether borderline personality disorder is a variant of bipolar disorder by examining the rates of co-occurrence in both disorders, the effects of co-occurrence on a longitudinal course, and whether the presence of either disorder confers the risk for new onsets of the other.


METHODS
A prospective repeated-measures design with reliable independent diagnostic measures and 4 years of follow-up was used to assess 196 patients with borderline personality disorder and 433 patients with other personality disorders.


RESULTS
Patients with borderline personality disorder had a significantly higher co-occurrence of bipolar disorder (19.4%) than did patients with other personality disorders. However, this co-occurrence did not appear to affect the subsequent course of borderline personality disorder. Although only 8.2% of the borderline personality disorder patients developed new onsets of bipolar disorder, this rate was higher than in patients with other personality disorders. Patients with other personality disorders with co-occurring bipolar disorder generally had more new onsets of borderline personality disorder (25%) than did patients with other personality disorders without co-occurring bipolar disorder (10%).


CONCLUSIONS
A modest association between borderline personality disorder and bipolar disorder is reported.
Gunderson
John G
JG
McLean Hospital, Department of Psychiatry, Belmont, MA. psychosocial@mcleanpo.mclean.org
Weinberg
Igor
I
Daversa
Maria T
MT
Kueppenbender
Karsten D
KD
Zanarini
Mary C
MC
Shea
M Tracie
MT
Skodol
Andrew E
AE
Sanislow
Charles A
CA
Yen
Shirley
S
Morey
Leslie C
LC
Grilo
Carlos M
CM
McGlashan
Thomas H
TH
Stout
Robert L
RL
Dyck
Ingrid
I
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D016009:Chi-Square Distribution; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors