Presence and Overlap of Bipolar Symptoms and Borderline Features during Major Depressive Episodes

Socada, J. Lumikukka; Söderholm, John J; Rosenström, Tom; Ekelund, Jesper; Isometsä, Erkki

doi:10.1016/j.jad.2020.11.043

Cited by 12 publications

(17 citation statements)

References 37 publications

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“…For more details of the recruitment process, the inclusion and exclusion criteria, and detailed statistics, please see SÖderholm and colleagues 25 and Socada and colleagues. 26 We further excluded 13 patients because they did not successfully complete the visual contrast tests. Altogether, we assessed 111 patients and 29 controls.…”

Section: Introductionmentioning

confidence: 99%

Reduced visual contrast suppression during major depressive episodes

Salmela

Socada

Söderholm

et al. 2021

J Psychiatry Neurosci

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Background: Previous studies have suggested that processing of visual contrast information could be altered in major depressive disorder. To clarify the changes at different levels of the visual hierarchy, we behaviourally measured contrast perception in 2 centre-surround conditions, assessing retinal and cortical processing. Methods: As part of a prospective cohort study, our sample consisted of controls (n = 29; 21 female) and patients with unipolar depression, bipolar disorder and borderline personality disorder who had baseline major depressive episodes (n = 111; 74 female). In a brightness induction test that assessed retinal processing, participants compared the perceived luminance of uniform patches (presented on a computer screen) as the luminance of the backgrounds was varied. In a contrast suppression test that assessed cortical processing, participants compared the perceived contrast of gratings, which were presented with collinearly or orthogonally oriented backgrounds. Results: Brightness induction was similar for patients with major depressive episodes and controls (p = 0.60, d = 0.115, Bayes factor = 3.9), but contrast suppression was significantly lower for patients than for controls (p < 0.006, d = 0.663, Bayes factor = 35.2). We observed no statistically significant associations between contrast suppression and age, sex, or medication or diagnostic subgroup. At follow-up (n = 74), we observed some normalization of contrast perception. Limitations: We assessed contrast perception using behavioural tests instead of electrophysiology. Conclusion: The reduced contrast suppression we observed may have been caused by decreased retinal feedforward or cortical feedback signals. Because we observed intact brightness induction, our results suggest normal retinal but altered cortical processing of visual contrast during a major depressive episode. This alteration is likely to be present in multiple types of depression and to partially normalize upon remission.

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Section: Introductionmentioning

confidence: 99%

Reduced visual contrast suppression during major depressive episodes

Salmela

Socada

Söderholm

et al. 2021

J Psychiatry Neurosci

Self Cite

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“…Interestingly there was no data available for emerging BPD for cyclothymia although previous research comparing participants with BD and BPD found that participants with BPD too show similar or even higher levels of abnormal cyclothymic temperament (Eich et al, 2014 ; Nilsson, Jørgensen, Straarup, & Licht, 2010 ). Previous evidence also shows that hypomanic days were reported frequently in both the BD and BPD subcohort (Socada, Söderholm, Rosenström, Ekelund, & Isometsä, 2021 ). However, based on our findings while hypomanic symptoms predicted BD onset (Faedda et al, 2015 ), there was no data pertaining to BPD onset.…”

Section: Discussionmentioning

confidence: 67%

Understanding the development of bipolar disorder and borderline personality disorder in young people: a meta-review of systematic reviews

et al. 2022

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Background There is ongoing debate on the nosological position of bipolar disorder (BD) and borderline personality disorder (BPD). Identifying the unique and shared risks, developmental pathways, and symptoms in emerging BD and BPD could help the field refine aetiological hypotheses and improve the prediction of the onset of these disorders. This study aimed to: (a) systematically synthesise the available evidence from systematic reviews (SRs) and meta-analyses (MAs) concerning environmental, psychosocial, biological, and clinical factors leading to the emergence of BD and BPD; (b) identify the main differences and common features between the two disorders to characterise their complex interplay and, (c) highlight remaining evidence gaps. Methods Data sources were; PubMed, PsychINFO, Embase, Cochrane, CINAHL, Medline, ISI Web of Science. Overlap of included SRs/MAs was assessed using the corrected covered area process. The methodological quality of each included SR and MA was assessed using the AMSTAR. Results 22 SRs and MAs involving 249 prospective studies met eligibility criteria. Results demonstrated that family history of psychopathology, affective instability, attention deficit hyperactivity disorder, anxiety disorders, depression, sleep disturbances, substance abuse, psychotic symptoms, suicidality, childhood adversity and temperament were common predisposing factors across both disorders. There are also distinct factors specific to emerging BD or BPD. Conclusions Prospective studies are required to increase our understanding of the development of BD and BPD onset and their complex interplay by concurrently examining multiple measures in BD and BPD at-risk populations.

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“…BD II scored significantly high regarding total BPP score compared to other mood disorders. A previous study [ 31 ] suggested that hypomanic symptoms lead to an overlapping of BD II and BPP; and that affective instability, a feature of BPP, could influence this vulnerability towards hypomanic symptoms. In line with this previous study, we also observed that affective instability reflected a higher score in patients with BD II.…”

Section: Discussionmentioning

confidence: 99%

Borderline Personality Pathology in Major Depressive Disorder, Bipolar I and II Disorder, and Its Relationship With Childhood Trauma

You

Lee

Park

et al. 2022

Psychiatry Investig

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Objective Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls.Methods A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory–Borderline Features Scale.Results BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients.Conclusion The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.

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Presence and Overlap of Bipolar Symptoms and Borderline Features during Major Depressive Episodes

Cited by 12 publications

References 37 publications

Reduced visual contrast suppression during major depressive episodes

Reduced visual contrast suppression during major depressive episodes

Understanding the development of bipolar disorder and borderline personality disorder in young people: a meta-review of systematic reviews

Borderline Personality Pathology in Major Depressive Disorder, Bipolar I and II Disorder, and Its Relationship With Childhood Trauma

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