Abstract
BackgroundThe high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders.MethodsIn a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice.ResultsMore subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders.ConclusionsThe results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar spectrum. This association may reflect an etiological relationship or diagnostic overlapping criteria.
Highlights
Borderline personality disorder (BPD) has been considered as a threshold psychotic disorder [1]
Affective disorders are common among patients with BPD [3,4,5] and high rates of BPD have repeatedly been found among patients with depression [6,7,8]
The present study examines whether the prevalence of affective disorders in general, or unipolar depression, bipolar disorder, and dysthymia separately, are higher in persons with borderline personality disorder than in persons with other personality disorders
Summary
Borderline personality disorder (BPD) has been considered as a threshold psychotic disorder [1]. It has instead been associated with affective disorders [2]. Affective disorders are common among patients with BPD [3,4,5] and high rates of BPD have repeatedly been found among patients with depression [6,7,8]. A high rate of comorbidity is not sufficient to conclude that affective disorders are a part of the BPD condition. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders
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