Personality pathology among married adults with bipolar disorder

Carpenter, Daniel; Clarkin, John F.; Glick, Ira D.; Wilner, Philip J.

doi:10.1016/0165-0327(95)00024-h

Cited by 56 publications

(47 citation statements)

References 10 publications

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“…These findings are supported by several studies that have concluded that comorbid personality disorders in BP negatively affect patient outcomes (Barbato and Hafner, 1998;Bieling et al, 2003;Carpenter et al, 1995;Carpiniello et al, 2011;Colom et al, 2000;Dunayevich et al, 2000;George et al, 2003;Kay et al, 2002;Kutcher et al, 1990;Preston et al, 2004;Vieta et al, 1999;Winograd et al, 2008). Presence of high BPSS among BP adolescents may suggest the need to modify clinical monitoring and treatment practices.…”

Section: Discussionsupporting

confidence: 60%

“…Some studies report BPD as the most common personality disorder among adult BP patients (O'Connell et al, 1991;Peselow et al, 1995;Vieta et al, 1999). Adult BP patients with comorbid personality disorders have less favorable outcomes including longer and more frequent hospitalizations (Barbato and Hafner, 1998;Dunayevich et al, 2000), increased suicidal ideation and attempts (Carpiniello et al, 2011;Vieta et al, 1999), greater symptom severity and functional impairment (Barbato and Hafner, 1998;Carpenter et al, 1995;George et al, 2003), earlier age of mood symptom onset (Vieta et al, 1999), greater unemployment (Kay et al, 2002), higher rates of axis I comorbidity (Kay et al, 2002;Preston et al, 2004), and worsened long-term outcomes of symptomatic and functional recovery (Bieling et al, 2003;Dunayevich et al, 2000) compared to those without personality disorders. This comorbidity has been further associated with poor pharmacotherapy outcomes as evidenced by reduced compliance (Colom et al, 2000) and response to treatment (Barbato and Hafner, 1998), and necessity for polypharmacy (Kay et al, 2002).…”

Section: Introductionmentioning

confidence: 98%

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Significance of borderline personality-spectrum symptoms among adolescents with bipolar disorder

Fonseka

Swampillai

Timmins

et al. 2015

Journal of Affective Disorders

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 98%

Significance of borderline personality-spectrum symptoms among adolescents with bipolar disorder

Fonseka

Swampillai

Timmins

et al. 2015

Journal of Affective Disorders

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“…Such an association is noteworthy, since comorbid personality and anxiety disorders exacerbate bipolar disorder even without the negative effects of substance abuse (Young et al, 1993;Carpenter et al, 1995;Ucock et al, 1998;Dunayevich et al, 2000;Feske et al, 2000;George et al, 2003). Given the implications for the management of patients with bipolar disorder and concurrent substance, anxiety, and/ or personality disorder, care should be taken to identify comorbid psychiatric illness in any patient population.…”

Section: Discussionmentioning

confidence: 99%

Comorbid disorders in patients with bipolar disorder and concomitant substance dependence

Mitchell

Brown

Rush

2007

Journal of Affective Disorders

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Objective-Substance dependence is common in bipolar disorder and is associated with an increase in Axis I and II comorbidity. Little research has compareed the relative rates of comorbidity among bipolar patients with dependence on different substances. Methods-TheMini International Neuropsychiatric Interview (M.I.N.I.) was used to assess 166 outpatients involved in one of three clinical trials of medicatiosn for bipolar disorder and substance dependence. Patients had concurrent alcohol dependence, cocaine dependence, or both conditions.Results-Generalized anxiety disorder and current depressed mood were significantly more common in bipolar patients with alcohol dependence than bipolar patients with cocaine dependence. Those with cocaine dependence had significantly higher rates of post-traumatic stress disorder and anti-social personality disorder and were more likely to present in a mixed mood state than patients dependent on alcohol. Cocaine dependent patients were more likely than alcohol dependent patients to have bipolar I relative to bipolar II.Limitations-This is a retrospective, cross-sectional data analysis using the M.I.N.I. for diagnosis.Conclusions-Cocaine dependence and alcohol dependence were associated with different clinical features and comorbid disorders in bipolar patients. The results may help confirm the validity of integrative models of mood, behavioral, anxiety, and personality disorders. Further studies on the causal relationship between substance dependence and concurrent and lifetime Axis I disorders for patients with bipolar disorders are indicated.

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“…The presence of comorbid substance abuse was associated with a poorer outcome, with lower rates of remission (Goldberg et al, 1999) and more psychiatric hospitalizations (Sonne et al, 1994;Cassidy et al, 2001). Personality disorders were associated with poorer treatment outcomes (Kutcher et al, 1990;Gasperini et al, 1993;Carpenter et al, 1995;Solomon et al, 1995;Barbato and Hafner, 1998;Dunayevich et al, 2000), with more severe residual mood symptoms, even during remission (George et al, 2003), a higher number of currently prescribed psychiatric medications (Kay et al, 2002) and poorer medication compliance (Colom et al, 2000). Axis III comorbidities also affect outcomes of bipolar disorder (Cassidy et al, 1999;Fagiolini et al, 2003).…”

Section: Clinical Implications Of Comorbiditymentioning

confidence: 94%

Comorbidity in bipolar disorder: a framework for rational treatment selection

McIntyre

Konarski

Yatham

2004

Human Psychopharmacology

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Bipolar disorders are heterogeneous disorders often requiring multimodality treatment. The expanding pharmacopeia for bipolar disorders invites the need for a treatment framework that both recognizes and anticipates the multidimensionality and comorbidity of the illness. No available neurotherapeutic agent is singularly efficacious for the complete mélange of bipolar symptomatology. An apparent paradox has emerged in the management of bipolar disorder; whilst results from rigorous controlled monotherapy trials suggest that a disparate assortment of neurotherapeutic agents are efficacious in distinct phases of bipolar disorder, the majority of tertiary-treated bipolar patients receive polypharmacotherapeutic regimens. The evidentiary base for polypharmacotherapy is sparse and has recently become an area of active research focus. In the interim, clinicians are encouraged to invoke an organizational schema for the treatment of bipolar disorder that considers the spectrum of effectiveness of putative and established mood stabilizers. This schema should be further informed by the treatment data for comorbid and accessory conditions. The authors propose a schema to provide the impetus for further work in the area.

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Personality pathology among married adults with bipolar disorder

Cited by 56 publications

References 10 publications

Significance of borderline personality-spectrum symptoms among adolescents with bipolar disorder

Significance of borderline personality-spectrum symptoms among adolescents with bipolar disorder

Comorbid disorders in patients with bipolar disorder and concomitant substance dependence

Comorbidity in bipolar disorder: a framework for rational treatment selection

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