Citation

Perugi G, Angst J, Azorin JM, Bowden CL, Caciagli A, Mosolov S, Vieta E, Young AH. Acta Psychiatr. Scand. 2016; 133(2): 133-143.

Copyright

(Copyright © 2016, John Wiley and Sons)

DOI

10.1111/acps.12457

PMID

unavailable

Abstract

OBJECTIVE: The study focused on the relationship between mixed depression and borderline personality disorder (BPD).

METHOD: The sample comprised 2811 patients with a major depressive episode (MDE). Clinical characteristics were compared in patients with (BPD+) and without (BPD-) comorbid BPD and in BPD+ with (MXS+) and without (MXS-) mixed features according to DSM-5 criteria.

RESULTS: A total of 187 patients (6.7%) met the criteria for BPD. A DSM-IV-TR diagnosis of bipolar disorder (BD) was significantly more frequent in patients with BPD+ than in patients with BPD. Patients with BPD+ were significantly younger and reported lower age at onset than BPD- Patients with BPD+ also showed more hypomania/mania in first-degree relatives in comparison with patients with BPD-, as well as more psychiatric comorbidity, mixed features, atypical features, suicide attempts, prior mood episodes and antidepressant-induced hypo/manic switches. Mixed features according to DSM-5 criteria were observed in 52 (27.8%) BPD+. In comparison with MXS-, MXS+ were significantly younger at age of onset and at prior mood episode and had experienced more mood episodes and hypo/manic switches with antidepressant treatments.

CONCLUSION: Major depressive episode patients with comorbid BPD reported a high prevalence of mixed features and BD. The presence of DSM-5 mixed features in MDE patients with BPD may be associated with complex course and reduced treatment response. © 2016 John Wiley & Sons A/S.

Language: en

Keywords

adult; human; female; male; bipolar disorder; prevalence; aggression; suicide attempt; major depression; comorbidity; Major depression; major clinical study; antidepressant agent; neuroleptic agent; clinical feature; human relation; priority journal; paranoia; impulsiveness; borderline state; Borderline personality; onset age; bipolar I disorder; bipolar II disorder; hypomania; agitation; DSM-IV; mental instability; Mixed states; mood stabilizer; treatment response; Article; distractibility; hypersexuality; DSM-5; predictive value; DSM-IV-TR; first degree relative