David Baxter PhD
Late Founder
Bipolar disorder with BPD marked by high aggression and impulsivity
By Andrew Czyzewski, MedWire News
23 December 2010
Psychiatry Res 2010; Advance online publication
Bipolar disorder patients with comorbid borderline personality disorder (BPD) show a heightened level of impulsivity and aggression as well as a markedly elevated rate of suicide attempts relative to those with bipolar disorder alone, study results show.
The researchers say it is important to carry out a "comprehensive psychological evaluation" to screen for personality disorders in bipolar disorder.
"The debate as to whether or not to include BPD among mood-spectrum disorders is far from being concluded due to the sharing of several clinical features, in particular, impulsiveness, aggressiveness, and affective lability, which may explain the acknowledged difficulties in differential diagnosis at times encountered by clinicians," say Bernardo Carpiniello (University of Cagliari, Italy) and colleagues.
However, there have been no studies that have specifically evaluated the impact of BPD comorbidity on impulsivity and aggression in bipolar disorder patients.
To address this, the researchers recruited a total of 57 patients with bipolar disorder in clinical stable remission, of whom 18 (31.6%) also had BPD and 11 (19.3%) had other personality disorders (OPD).
They completed a structured clinical interview and were evaluated with the Barratt Impulsivity Scale (BIS-11) and the Aggression Questionnaire (AQ).
Patients with bipolar disorder and comorbid BPD showed the highest level of impulsivity followed by bipolar disorder plus OPD, then bipolar disorder alone, with mean BIS scores of 78.94, 68.64, and 60.29, respectively, out of a maximum of 120.
As reported in the journal of Psychiatry Research, a similar pattern was observed for aggression on the AQ scale with scores of 89.17, 73.55, and 69.96 for the respective diagnostic groups (maximum 116).
This appeared to extend to self-aggression, the researchers note, as the rate of attempted suicides was approximately three times higher in bipolar disorder plus BPD patients compared with those with bipolar disorder alone and 7.6 times higher than in patients with bipolar disorder plus OPD.
"Taken together, these results seem to demonstrate not only that impulsiveness and aggressiveness may be considered as 'traits' characterizing bipolar patients or BPD, but also that a higher level of these traits discriminate patients affected by bipolar disorder with BPD from 'pure' bipolar patients and from bipolar subjects with any OPD."
Abstract
By Andrew Czyzewski, MedWire News
23 December 2010
Psychiatry Res 2010; Advance online publication
Bipolar disorder patients with comorbid borderline personality disorder (BPD) show a heightened level of impulsivity and aggression as well as a markedly elevated rate of suicide attempts relative to those with bipolar disorder alone, study results show.
The researchers say it is important to carry out a "comprehensive psychological evaluation" to screen for personality disorders in bipolar disorder.
"The debate as to whether or not to include BPD among mood-spectrum disorders is far from being concluded due to the sharing of several clinical features, in particular, impulsiveness, aggressiveness, and affective lability, which may explain the acknowledged difficulties in differential diagnosis at times encountered by clinicians," say Bernardo Carpiniello (University of Cagliari, Italy) and colleagues.
However, there have been no studies that have specifically evaluated the impact of BPD comorbidity on impulsivity and aggression in bipolar disorder patients.
To address this, the researchers recruited a total of 57 patients with bipolar disorder in clinical stable remission, of whom 18 (31.6%) also had BPD and 11 (19.3%) had other personality disorders (OPD).
They completed a structured clinical interview and were evaluated with the Barratt Impulsivity Scale (BIS-11) and the Aggression Questionnaire (AQ).
Patients with bipolar disorder and comorbid BPD showed the highest level of impulsivity followed by bipolar disorder plus OPD, then bipolar disorder alone, with mean BIS scores of 78.94, 68.64, and 60.29, respectively, out of a maximum of 120.
As reported in the journal of Psychiatry Research, a similar pattern was observed for aggression on the AQ scale with scores of 89.17, 73.55, and 69.96 for the respective diagnostic groups (maximum 116).
This appeared to extend to self-aggression, the researchers note, as the rate of attempted suicides was approximately three times higher in bipolar disorder plus BPD patients compared with those with bipolar disorder alone and 7.6 times higher than in patients with bipolar disorder plus OPD.
"Taken together, these results seem to demonstrate not only that impulsiveness and aggressiveness may be considered as 'traits' characterizing bipolar patients or BPD, but also that a higher level of these traits discriminate patients affected by bipolar disorder with BPD from 'pure' bipolar patients and from bipolar subjects with any OPD."
Abstract
