TY  - JOUR
PY  - 2005//
TI  - Bipolar disorder with comorbid cluster B personality disorder features: impact on suicidality
JO  - Journal of clinical psychiatry
A1  - Garno, Jessica L.
A1  - Goldberg, Joseph F.
A1  - Ramirez, Paul Michael
A1  - Ritzler, Barry A.
SP  - 339
EP  - 345
VL  - 66
IS  - 3
N2  - BACKGROUND: Because of their overlapping phenomenology and mutually chronic, persistent nature, distinctions between bipolar disorder and cluster B personality disorders remain a source of unresolved clinical controversy. The extent to which comorbid personality disorders impact course and outcome for bipolar patients also has received little systematic study. METHOD: One hundred DSM-IV bipolar I (N = 73) or II (N = 27) patients consecutively underwent diagnostic evaluations with structured clinical interviews for DSM-IV Axis I and cluster B Axis II disorders, along with assessments of histories of childhood trauma or abuse. Cluster B diagnostic comorbidity was examined relative to lifetime substance abuse, suicide attempt histories, and other clinical features. RESULTS: Thirty percent of subjects met DSM-IV criteria for a cluster B personality disorder (17% borderline, 6% antisocial, 5% histrionic, 8% narcissistic). Cluster B diagnoses were significantly linked with histories of childhood emotional abuse (p = .009), physical abuse (p = .014), and emotional neglect (p = .022), but not sexual abuse or physical neglect. Cluster B comorbidity was associated with significantly more lifetime suicide attempts and current depression. Lifetime suicide attempts were significantly associated with cluster B comorbidity (OR = 3.195, 95% CI = 1.124 to 9.088), controlling for current depression severity, lifetime substance abuse, and past sexual or emotional abuse. CONCLUSIONS: Cluster B personality disorders are prevalent comorbid conditions identifiable in a substantial number of individuals with bipolar disorder, making an independent contribution to increased lifetime suicide risk.<p /> <p>Language: en</p>
LA  - en
SN  - 0160-6689
UR  - http://dx.doi.org/
ID  - ref1
ER  -