title: Personality disorder symptom severity predicts onset of mood episodes and conversion to bipolar I disorder in individuals with bipolar spectrum disorder.
abstract: Although personality disorders (PDs) are highly comorbid with bipolar spectrum disorders (BSDs), little longitudinal research has been conducted to examine the prospective impact of PD symptoms on the course of BSDs. The aim of this study is to examine whether PD symptom severity predicts shorter time to onset of bipolar mood episodes and conversion to bipolar I disorder over time among individuals with less severe BSDs. Participants (n = 166) with bipolar II disorder, cyclothymia, or bipolar disorder not otherwise specified completed diagnostic interview assessments of PD symptoms and self-report measures of mood symptoms at baseline. They were followed prospectively with diagnostic interviews every 4 months for an average of 3.02 years. Cox proportional hazard regression analyses indicated that overall PD symptom severity significantly predicted shorter time to onset of hypomanic (hazard ratio [HR] = 1.42; p < .001) and major depressive episodes (HR = 1.51; p < .001) and conversion to bipolar I disorder (HR = 2.51; p < .001), after controlling for mood symptoms. Results also suggested that cluster B severity predicted shorter time to onset of hypomanic episodes (HR = 1.38; p = .002) and major depressive episodes (HR = 1.35; p = .01) and conversion to bipolar I disorder (HR = 2.77; p < .001), whereas cluster C severity (HR = 1.56; p < .001) predicted shorter time to onset of major depressive episodes. These results support predisposition models in suggesting that PD symptoms may act as a risk factor for a more severe course of BSDs. (PsycINFO Database Record
authors.affiliation: Department of Psychology.
authors.forename: Tommy H
authors.initials: TH
authors.lastname: Ng
authors.affiliation: Department of Psychology.
authors.forename: Taylor A
authors.initials: TA
authors.lastname: Burke
authors.affiliation: Department of Psychiatry, University of Illinois-Chicago.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Stange
authors.affiliation: Semel Institute for Neuroscience and Human Behavior, University of California.
authors.forename: Patricia D
authors.initials: PD
authors.lastname: Walshaw
authors.affiliation: Department of Psychiatry, McLean Hospital.
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Weiss
authors.affiliation: Department of Psychiatry, University of Minnesota.
authors.forename: Snezana
authors.initials: S
authors.lastname: Urosevic
authors.affiliation: Department of Psychology, University of Wisconsin-Madison.
authors.forename: Lyn Y
authors.initials: LY
authors.lastname: Abramson
authors.affiliation: Department of Psychology.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Alloy
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis*; D003863:Depression / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000175:diagnosis*; D010554:Personality Disorders / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult