The International Mood Network (IMN) Nosology Project: differentiating borderline personality from bipolar illness

Autor:	S. Medina, Paul A. Vöhringer, P. Riumallo, M. E. Hurtado, Matthew C. Sullivan, Juan Cabrera, Katherine Alvear, C. Espinosa, K. Alexandrovich, Niki S. Holtzman, Sergio Barroilhet, F. Leiva, S. N. Ghaemi
Rok vydání:	2016
Předmět:	Nosology Predictive validity Adult Male medicine.medical_specialty Bipolar Disorder media_common.quotation_subject Logistic regression Sensitivity and Specificity Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Borderline Personality Disorder mental disorders medicine Personality Humans Medical diagnosis Psychiatry Borderline personality disorder media_common Models Statistical Mood Disorders Mood Disorder Questionnaire Middle Aged medicine.disease 030227 psychiatry Psychiatry and Mental health Mood Cross-Sectional Studies Female Psychology 030217 neurology & neurosurgery Clinical psychology
Zdroj:	Acta psychiatrica Scandinavica. 134(6)
ISSN:	1600-0447
Popis:	Objective The differential diagnosis of bipolar illness vs. borderline personality is controversial. Both conditions manifest impulsive behavior, unstable interpersonal relationships, and mood symptoms. This study examines whether and which mood clinical features can differentiate between both conditions. Method A total of 260 patients (mean ± standard deviation age 41 ± 13 years, 68% female) attending to a mood clinic were examined for diagnosis of bipolar illness and borderline personality disorder using SCID-I, SCID-II, and clinical mood criteria extracted from Mood Disorder Questionnaire (MDQ). They were analyzed using diagnoses as dependent variables. Predictors of bipolar and borderline diagnoses were identified by multivariable logistic regressions, and predictive validity of models was assessed using ROC curve analysis. Results Bipolar illness was strongly predicted by elevated mood (OR = 4.02, 95% CI: 1.80–9.15), increased goal-directed activities (OR = 3.90, 95% CI: 1.73–8.96), and episodicity of mood symptoms (OR = 3.48, 95% CI 1.49–8.39). This triad model predicted bipolar illness with 88.7% sensitivity, 81.4% specificity, and obtained an auROC of 0.91 (95% CI: 0.76–0.96) and a positive predictive value of 85.1%. For borderline personality disorder, only female gender was a statistically significant predictor (OR = 3.41, 95% CI: 1.29–13.7), and the predictive model obtained an auROC of 0.67 (95% CI: 0.53–0.74). Conclusion In a mood disorder clinic setting, manic criteria and episodic mood course distinguished bipolar illness from borderline personality disorder.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::076121f1ddd068a5bf07735e9958a325 https://pubmed.ncbi.nlm.nih.gov/27611723 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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