Abstract
BackgroundScreening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. This study examined the accuracy of these scales for detecting bipolar disorder among patients referred for eating disorders and explored the possibility of simultaneous assessment of co-morbid borderline personality disorder.MethodsParticipants were 78 consecutive female patients who were referred for evaluation of an eating disorder. All participants completed the mood and eating disorder sections of the SCID-I/P and the borderline personality disorder section of the SCID-II, in addition to the MDQ and BSDS. Predictive validity of the MDQ and BSDS was evaluated by Receiver Operating Characteristic analysis of the Area Under the Curve (AUC).ResultsFifteen (19%) and twelve (15%) patients fulfilled criteria for bipolar II disorder and borderline personality disorder, respectively. The AUCs for bipolar II disorder were 0.78 (MDQ) and 0.78 (BDSD), and the AUCs for borderline personality disorder were 0.75 (MDQ) and 0.79 (BSDS).ConclusionsAmong patients being evaluated for eating disorders, the MDQ and BSDS show promise as screening questionnaires for both bipolar disorder and borderline personality disorder.
Highlights
Screening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder
Statistical analysis We examined the diagnostic accuracy of the MDQ and BSDS for bipolar as well as personality disorders, using the SCID-I and II as the gold standard diagnostic tool
The MDQ and BSDS offer reasonably comparable diagnostic accuracy in the form of a self-report measure that requires much less time, expertise, and resources to administer than the SCID or Composite International Diagnostic Interview (CIDI)
Summary
Screening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. As bipolar disorders are serious mental disorders that can cause severe lifelong functional impairment, early recognition of the diagnosis and early introduction of mood stabilizers are crucial for improvement of outcomes [1]. There are two viewpoints about the relationship between bipolar disorder, especially bipolar II disorder, and borderline personality disorder. Others insist that there is clear boundary between bipolarity and borderline personality disorder, and they resist the expansion of bipolar disorder as an invasion of “bipolar imperialism” toward other diagnostic categories [5]
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