title: Comorbidity bipolar disorder and personality disorders.
abstract: BACKGROUND
  Outcome in bipolar patients can be affected by comorbidity of other psychiatric disorders. Comorbid personality disorders are frequent and may complicate the course of bipolar illness. We have much information about treating patients with uncomplicated bipolar disorder (BD) but much less knowledge about possibilities for patients with the comorbidity of BD and personality disorder.
  
  
  METHODS
  We conducted a series of literature searches using, as key words or as items in indexed fields, bipolar disorder and personality disorder or personality traits. Articles were obtained by searching MEDLINE from 1970 to 2012. In addition, we used other papers cited in articles from these searches, or cited in articles used in our own work.
  
  
  RESULTS
  Tests of personality traits indicated that euthymic bipolar patients have higher scores on harm avoidance, reward dependence, and novelty seeking than controls. Elevation of novelty seeking in bipolar patients is associated with substance abuse comorbidity.
  
  
  CONCLUSIONS
  Comorbidity with personality disorders in BD patients is associated with a more difficult course of illness (such as longer episodes, shorter time euthymic, and earlier age at onset) and an increase in comorbid substance abuse, suicidality and aggression. These problems are particularly pronounced in comorbidity with borderline personality disorder. Comorbidity with antisocial personality disorder elicits a similar spectrum of difficulties; some of the antisocial behavior exhibited by patients with this comorbidity is mediated by increased impulsivity.
authors.affiliation: Department of Psychiatry, Palacky University Olomouc, University Hospital Olomouc, Czech Republic. klaralat@centrum.cz
authors.forename: Klara
authors.initials: K
authors.lastname: Latalova
authors.forename: Jan
authors.initials: J
authors.lastname: Prasko
authors.forename: Dana
authors.initials: D
authors.lastname: Kamaradova
authors.forename: Jana
authors.initials: J
authors.lastname: Sedlackova
authors.forename: Marie
authors.initials: M
authors.lastname: Ociskova
mesh_terms: D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D005106:Exploratory Behavior; D006801:Humans; D010554:Personality Disorders / Q000453:epidemiology*; D012201:Reward; D019966:Substance-Related Disorders / Q000453:epidemiology*