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Descriptive and longitudinal observations on the relationship of borderline personality disorder and bipolar disorder.

Gunderson JG, Weinberg I, Daversa MT, Kueppenbender KD, Zanarini MC, Shea MT, Skodol AE, Sanislow CA, Yen S, Morey LC, Grilo CM, McGlashan TH, Stout RL, Dyck I

McLean Hospital, Department of Psychiatry, Belmont, MA. psychosocial@mcleanpo.mclean.org

OBJECTIVE: The purpose of this study was to test whether borderline personality disorder is a variant of bipolar disorder by examining the rates of co-occurrence in both disorders, the effects of co-occurrence on a longitudinal course, and whether the presence of either disorder confers the risk for new onsets of the other. METHOD: A prospective repeated-measures design with reliable independent diagnostic measures and 4 years of follow-up was used to assess 196 patients with borderline personality disorder and 433 patients with other personality disorders. RESULTS: Patients with borderline personality disorder had a significantly higher co-occurrence of bipolar disorder (19.4%) than did patients with other personality disorders. However, this co-occurrence did not appear to affect the subsequent course of borderline personality disorder. Although only 8.2% of the borderline personality disorder patients developed new onsets of bipolar disorder, this rate was higher than in patients with other personality disorders. Patients with other personality disorders with co-occurring bipolar disorder generally had more new onsets of borderline personality disorder (25%) than did patients with other personality disorders without co-occurring bipolar disorder (10%). CONCLUSIONS: A modest association between borderline personality disorder and bipolar disorder is reported.

Published 3 July 2006 in Am J Psychiatry, 163(7): 1173-8.
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