title: Co-morbidity of bipolar disorder and borderline personality disorder: findings from the National Epidemiologic Survey on Alcohol and Related Conditions.
abstract: OBJECTIVE
  Clinical studies suggest a high co-morbidity rate of borderline personality disorder (BPD) with bipolar disorder (BD). This study examines the prevalence and correlates of BPD in BD (I and II) in a longitudinal population-based survey.
  
  
  METHODS
  Data came from waves 1 and 2 (wave 2: N=34,653, 70.2% cumulative response rate; age ≥ 20 years) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Lay interviewers conducted in person interviews using the Alcohol Use Disorders and Associated Disabilities Interview (AUDADIS-IV), a reliable diagnostic tool of psychiatric disorders based on DSM-IV criteria. Subjects with BD I (n=812), BD I/BPD (n=360), BD II (n=327) and BD II/BPD (n=101) were examined in terms of sociodemographics, mood, anxiety, substance use and personality disorder co-morbidities and history of childhood traumatic experiences.
  
  
  RESULTS
  Lifetime prevalence of BPD was 29.0% in BD I and 24.0% in BD II. Significant differences were observed between co-morbid BD I/II and BPD versus BD I/II without BPD in terms of number of depressive episodes and age of onset, co-morbidity, and childhood trauma. BPD was strongly and positively associated with incident BD I (AOR=16.9; 95% CI: 13.88-20.55) and BD II (AOR=9.5; 95% CI: 6.44-13.97).
  
  
  CONCLUSIONS
  BD with BPD has a more severe presentation of illness than BD alone. The results suggest that BPD is highly predictive of a future diagnosis of BD. Childhood traumatic experiences may have a role in understanding this relationship.
authors: PGY-6 Child and Adolescent Psychiatry, Department of Psychiatry, University of Manitoba. Electronic address: joeymcdermid@gmail.com.
authors: Joanna
authors: J
authors: McDermid
authors: Department of Psychiatry, University of Manitoba; Department of Psychology, University of Manitoba; Department of Community Health Sciences, University of Manitoba. Electronic address: sareen@cc.umanitoba.ca.
authors: Jitender
authors: J
authors: Sareen
authors: Department of Psychiatry, University of Manitoba; Department of Psychology, University of Manitoba. Electronic address: umelgaba@cc.umanitoba.ca.
authors: Renée
authors: R
authors: El-Gabalawy
authors: Department of Pediatrics, University of Manitoba. Electronic address: pagura.jina@gmail.com.
authors: Jina
authors: J
authors: Pagura
authors: Department of Psychiatry, University of Manitoba; Department of Community Health Sciences, University of Manitoba. Electronic address: rspiwak@gmail.com.
authors: Rae
authors: R
authors: Spiwak
authors: Department of Psychiatry, University of Manitoba. Electronic address: menns@hsc.mb.ca.
authors: Murray W
authors: MW
authors: Enns
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D017668:Age of Onset; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D001883:Borderline Personality Disorder / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D055815:Young Adult