Differential diagnosis of bipolar affective disorder type II and borderline personality disorder: analysis of the affective dimension

Renaud, Suzane; Corbalán, Fernando; Beaulieu, Serge

doi:10.1016/j.comppsych.2012.03.004

Cited by 37 publications

(27 citation statements)

References 99 publications

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“…These episodes are rather cyclical and include sustained euphoric periods. 110,112 Distinguishing the disorders is clinically important, because of the marked differences in treatments for BPD or bipolar II.…”

Section: Differential Diagnosesmentioning

confidence: 99%

Borderline Personality Disorder in Adolescence

2014

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This is the 4th in our series on Adolescent Health. abstract Borderline personality disorder (BPD) is a common and severe mental disorder that is associated with severe functional impairment and a high suicide rate. BPD is usually associated with other psychiatric and personality disorders, high burden on families and carers, continuing resource utilization, and high treatment costs. BPD has been a controversial diagnosis in adolescents, but this is no longer justified. Recent evidence demonstrates that BPD is as reliable and valid among adolescents as it is in adults and that adolescents with BPD can benefit from early intervention. Consequently, adolescent BPD is now recognized in psychiatric classification systems and in national treatment guidelines. This review aims to inform practitioners in the field of adolescent health about the nature of BPD in adolescence and the benefits of early detection and intervention. BPD diagnosis and treatment should be considered part of routine practice in adolescent mental health to improve these individuals' well-being and long-term prognosis.

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Section: Differential Diagnosesmentioning

confidence: 99%

Borderline Personality Disorder in Adolescence

2014

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“…In a review Paris et al [38] conclude that BPD and BD may co-occur, but their relationship is not consistent or specific. More knowledge about co-occurrence and comorbidity of these disorders may have an important clinical relevance in order to plan appropriate treatment [39]. It is expected that a psychological treatment aimed at improving emotion regulation will have a positive effect on symptoms of personality disorder as well as BD, and will contribute to an increased quality of life and less care consumption in patients with complex emotional instability.…”

Section: Discussionmentioning

confidence: 99%

The addition of STEPPS in the treatment of patients with bipolar disorder and comorbid borderline personality features: a protocol for a randomized controlled trial

et al. 2014

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BackgroundBipolar disorder (BD) and borderline personality disorder (BPD) both are severe and chronic psychiatric disorders. Both disorders have overlapping symptoms, and current research shows that the presence of a BPD has an adverse effect on the course of BD. The limited research available shows an unfavorable illness course, a worse prognosis and response to medication, longer treatment duration, more frequent psychiatric admissions, higher drop-out, increased risk of substance abuse, increased risk of suicide, and more impairment of social and occupational functioning. However, there is no research available on the effect of specific psychotherapeutic treatment for this patients.Methods/DesignThis paper presents the protocol of a RCT to investigate the presence of borderline personality features in patients treated for BD (study part 1) and the effectiveness of STEPPS (Systems Training for Emotional Predictability and Problem Solving) added to treatment as usual (TAU) for BD compared to TAU in patients with BD and comorbid borderline personality features (study part 2). STEPPS is a validated and effective intervention for BPD. The study population consists of patients treated for BD at specialized outpatient clinics for BD in the Netherlands. At first the prevalence of comorbid borderline personality features in outpatients with BD is investigated. Inclusion criteria for study part 2 is defined as having three or more of the DSM-IV-TR diagnostic criteria of BPD, including impulsivity and anger bursts. Primary outcomes will be the frequency and severity of manic and depressive recurrences as well as severity, course and burden of borderline personality features. Secondary outcomes will be quality of life, utilizing mental healthcare and psychopathologic symptoms not primarily related to BD or BPD. Assessment will be at baseline, at the end of the intervention, and at 12 and 18 months follow-up.DiscussionThis will be the first randomized controlled trial of a specific intervention in patients with BD and comorbid BPD or borderline personality features. There are no recommendations in the guideline of treatment of bipolar disorders for patients with this complex comorbidity. We expect that a combined treatment aimed at mood disorder and emotion regulation will improve treatment outcomes for these patients.

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“…The differing emotion regulation profiles observed between the disorders might be accounted for by disorder-specific processes, with emotional dysregulation in those with BPD generally considered to be reactive and precipitated by stressors or interpersonal difficulties, (Renaud et al, 2012), and which might reflect behavioural sensitization -in which repeated exposure to a particular stressor (e.g. ongoing abuse or neglect) evokes strong reactions (Post and Weiss, 1998).…”

Section: Introductionmentioning

confidence: 98%

“…Linehan's (1993) 'biosocial theory' of the development of ED in BPD proposes its emergence from an individual's predispositional emotional sensitivity combined with an invalidating early environment. In BP disorders, ED is considered to be more autonomous and internally driven (Renaud et al, 2012), and also less reactive to psychosocial cues. Green et al (2007Green et al ( , 2011 suggested deficits in cognitive reframing strategies in BP disorder might reflect inherited neurocognitive deficits in frontal-executive function or could be related to environmental factors such as family dynamics and early learning experiences.…”

Section: Introductionmentioning

confidence: 99%