Unblending Borderline Personality and Bipolar Disorders.
Borderline Personality (BPD) and Bipolar (BP) disorders stimulate an academic debate between their distinction and the inclusion of Borderline in the Bipolar spectrum. Opponents to this inclusion attribute the important differences and possible diagnostic incomprehension to overlapping symptoms. We tested 248 Borderline and 113 Bipolar patients, consecutively admitted to the Psychiatric Unit, through DSM-IV Axis I and II Disorders (SCID-I/II), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Young Mania Rating Scale (YMRS) and Borderline Personality Disorder Severity Index-IV (BPDSI-IV). All the tests statistically discriminated the disorders (p < 0.0001). Overlapping symptoms resulted significantly different (impulsivity = 5.32 in BPD vs 1.55 in BP, p < 0.0001; emotional instability = 7.11 in BPD vs 0.55 in BP, p < 0.0001) and the range of their scores gives the opportunity for an even more precise discrimination. Distinctive traits (e.g. irritability or sexual arousal) are also discussed in order to try to qualify the core of these disorders to a higher degree. Comorbidity proves to be extremely small (3.6%). However, Borderline patients with manic features offer a privileged point of view for a deeper analysis. This allows for the possibility of a more precise examination of the nature and load of each symptom. Borderline Personality and Bipolar Disorders can be distinguished with high precision using common and time-sparing tests. The importance of discriminating these clinical features may benefit from this evidence.
School of Medicine and Surgery, University of Milano Bicocca, Italy; Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy; Doctorate School of the University of Milano-Bicocca, Italy. Electronic address: ester.digiacomo@yahoo.com.
Ester
E
di Giacomo
Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy.
Flora
F
Aspesi
Female Medium Secure Forensic Service, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.
Maria
M
Fotiadou
Department of Clinical Psychology, University of Amsterdam, The Netherlands.
Arnoud
A
Arntz
Department of Clinical and Molecular Biomedicine, University of Catania, Italy.
Eugenio
E
Aguglia
University of Pavia, Department of Brain and Behavioral Science, Psychology Section, Pavia, Italy.
Lavinia
L
Barone
Center for Personality Disorders, Psychiatric Clinic, Department of Neuroscience, University of Turin, Italy.
Silvio
S
Bellino
Department of Public Health, Clinical and Molecular Medicine - Psychiatric Unit, University of Cagliari, Italy.
Bernardo
B
Carpiniello
Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy.
Fabrizia
F
Colmegna
Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy.
Marina
M
Lazzari
Department of Biomedical Science, Psychiatric Clinic, University of Sassari, Italy.
Liliana
L
Lorettu
Department of Public Health, Clinical and Molecular Medicine - Psychiatric Unit, University of Cagliari, Italy.
Federica
F
Pinna
Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy.
Aldo
A
Sicaro
Department of Clinical and Molecular Biomedicine, University of Catania, Italy.
Maria Salvina
MS
Signorelli
School of Medicine and Surgery, University of Milano Bicocca, Italy; Psychiatric Department-S.Gerardo, Health Care Trust, Monza, Italy.
Massimo
M
Clerici
D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales
Bipolar Disorder; Borderline Personality Disorder; Clinical aspects; Diagnosis; Epidemiology