Acute treatment outcomes in patients with bipolar I disorder and co-morbid borderline personality disorder receiving medication and psychotherapy
- PMID: 15762861
- DOI: 10.1111/j.1399-5618.2005.00179.x
Acute treatment outcomes in patients with bipolar I disorder and co-morbid borderline personality disorder receiving medication and psychotherapy
Abstract
Objective: Patients suffering from both bipolar I disorder and borderline personality disorder (BPD) pose unique treatment challenges. The purpose of this matched case-control study was to compare acute treatment outcomes of a sample of patients who met standardized diagnostic criteria for both bipolar I disorder and BPD (n = 12) to those who met criteria for bipolar I disorder only (n = 58).
Method: Subjects meeting criteria for an acute affective episode were treated with a combination of algorithm-driven pharmacotherapy and weekly psychotherapy until stabilization (defined as four consecutive weeks with a calculated average of the 17-item version of the Hamilton Rating Scale for Depression and Bech-Rafaelsen Mania scale totaling < or = 7).
Results: Only three of 12 (25%) bipolar-BPD patients achieved stabilization, compared with 43 of 58 (74%) bipolar-only patients. Two of the three bipolar-BPD patients who did stabilize took over 95 weeks to do so, compared with a median time-to-stabilization of 35 weeks in the bipolar-only group. The bipolar-BPD group received significantly more atypical mood-stabilizing medications per year than the bipolar-only group (Z = 4.3, p < 0.0001). Dropout rates in the comorbid group were high.
Conclusions: This quasi-experimental study suggests that treatment course may be longer in patients suffering from both bipolar I disorder and BPD. Some patients improved substantially with pharmacotherapy and psychotherapy, suggesting that this approach is worthy of further investigation.
Similar articles
-
Borderline personality disorder and bipolar disorder comorbidity in suicidal patients: diagnostic and therapeutic challenges.Psychiatr Danub. 2009 Sep;21(3):386-90. Psychiatr Danub. 2009. PMID: 19794362
-
Treatments for late-life bipolar disorder.Am J Geriatr Pharmacother. 2006 Dec;4(4):347-64. doi: 10.1016/j.amjopharm.2006.12.007. Am J Geriatr Pharmacother. 2006. PMID: 17296540 Review.
-
Predictors of switching from mania to depression in a large observational study across Europe (EMBLEM).J Affect Disord. 2009 Nov;118(1-3):118-23. doi: 10.1016/j.jad.2009.02.007. Epub 2009 Mar 9. J Affect Disord. 2009. PMID: 19269690
-
A prospective 4-5 year follow-up of juvenile onset bipolar disorder.Bipolar Disord. 2004 Oct;6(5):386-94. doi: 10.1111/j.1399-5618.2004.00149.x. Bipolar Disord. 2004. PMID: 15383131 Clinical Trial.
-
Disability and its treatment in bipolar disorder patients.Bipolar Disord. 2007 Feb-Mar;9(1-2):183-96. doi: 10.1111/j.1399-5618.2007.00430.x. Bipolar Disord. 2007. PMID: 17391360 Review.
Cited by
-
Personality pathology predicts outcomes in a treatment-seeking sample with bipolar I disorder.Depress Res Treat. 2014;2014:816524. doi: 10.1155/2014/816524. Epub 2014 Jan 2. Depress Res Treat. 2014. PMID: 24516762 Free PMC article.
-
Asenapine in the management of impulsivity and aggressiveness in bipolar disorder and comorbid borderline personality disorder: an open-label uncontrolled study.Int Clin Psychopharmacol. 2018 May;33(3):121-130. doi: 10.1097/YIC.0000000000000206. Int Clin Psychopharmacol. 2018. PMID: 29189421 Free PMC article.
-
Problematic boundaries in the diagnosis of bipolar disorder: the interface with borderline personality disorder.Curr Psychiatry Rep. 2013 Dec;15(12):422. doi: 10.1007/s11920-013-0422-z. Curr Psychiatry Rep. 2013. PMID: 24254199 Review.
-
Treatment-resistant and multi-therapy-resistant criteria for bipolar depression: consensus definition.Br J Psychiatry. 2019 Jan;214(1):27-35. doi: 10.1192/bjp.2018.257. Epub 2018 Dec 6. Br J Psychiatry. 2019. PMID: 30520709 Free PMC article.
-
Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder.Dialogues Clin Neurosci. 2007;9(3):325-32. doi: 10.31887/DCNS.2007.9.3/efrank. Dialogues Clin Neurosci. 2007. PMID: 17969869 Free PMC article. Review.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous