The bipolar-borderline personality disorders connection in major depressive patients

Abstract

In our sample, selected on the basis of the presence of a mood disorder, the BD-BPD connection is confirmed by the high prevalence of bipolarity in depressive patients with BPD and by the significant association with familial and clinical features classically considered as external validators of bipolarity.

General medical conditions in 347 bipolar disorder patients: Clinical correlates of metabolic and autoimmune-allergic diseases

“…Mood reactivity, emotional instability and related separation and rejection sensitivity characterize this subgroup of BD patients (Perugi et al, 2013a(Perugi et al, , 2013bPerugi et al, 2011). Our findings suggest a possible relationship between autoimmune mediated inflammatory process, trait emotional reactivity and stress vulnerability.…”

Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder

“…Expressed in phenomenological terms, the moodiness, impulsivity, and interpersonal problems of cyclothymic patients are similar to those described in DSM-5 cluster B personality disorder (Henry et al, 2001;Mackinnon and Pies, 2006;Perugi et al, 2011). In many cases, the distinction from histrionic or borderline personality disorders (BPD) mainly depends on the perspective and moment of observation, rather than on real clinical differences (Levitt et al, 1990;Perugi et al, 2013a).…”

“…In two multicenter, multinational cross-sectional clinical studies on two very large clinical samples of patients with MDE, lifetime comorbidity with BPD was significantly associated with the various different diagnostic definitions and with all the external validators of bipolarity (Perugi et al, 2013b). The association was particularly striking for mania and hypomania in first-degree family members and the presence of mixed features during the current depressive episode (Perugi et al, 2013a). In addition, consistently with previous observations (Levy et al, 1998;Stone, 2006), BPD proved to be a predictive factor for antidepressants-induced hypomania (Perugi et al, 2013a(Perugi et al, , 2013b.…”

“…The association was particularly striking for mania and hypomania in first-degree family members and the presence of mixed features during the current depressive episode (Perugi et al, 2013a). In addition, consistently with previous observations (Levy et al, 1998;Stone, 2006), BPD proved to be a predictive factor for antidepressants-induced hypomania (Perugi et al, 2013a(Perugi et al, , 2013b. Furthermore, several follow-up studies have suggested a close correlation of BPD with mood disorders, considering the number of young borderline patients who, over the years, developed bipolar I or, more frequently, bipolar II disorder (Gunderson et al, 2006).…”

“…This can be particularly important in young people, in whom moderate or severe irritability, associated with aggression and outward hostility, has been reported in over 90% of the cases examined, during periods in which mood is elevated (Jensen et al, 2007;Masi et al, 2007). The presence of irritability during hypomania could be a factor in the frequent misdiagnosis of cyclothymia as depression (Utsumi et al, 2006) or personality disorder (Perugi et al, 2011(Perugi et al, , 2013a(Perugi et al, , 2013bStone, 2013b).…”