Beyond the Categorical Distinction Between Borderline Personality Disorder and Bipolar II Disorder Through the Identification of Personality Traits Profiles

Abstract

Background: The relationship between borderline personality disorder (BPD) and type-II bipolar disorder (BDII) is not clearly understood. Nevertheless, in clinical practice and research, most efforts focus on establishing a categorical distinction between the two. We propose using personality traits as a more informative strategy to describe them. Methods: Five-Factor Model personality traits were measured in 73 individuals with either BPD or BDII. Latent class cluster analysis was applied to the sample. Results: A three-cluster model resulted the best fit to the data, where all clusters had high neuroticism and low extraversion scores but differed widely on the other traits. The clusters' boundaries did not match the categorical diagnosis. Conclusions: Our sample showed significant heterogeneity on personality traits, which can have a relevant effect on the outcome of each disorder and that was not captured by the categorical diagnosis. Thus, we advocate for a multivariate approach as a better way to understand the relationship between BPD and BDII.

Clinical Features, Neuropsychology and Neuroimaging in Bipolar and Borderline Personality Disorder: A Systematic Review of Cross-Diagnostic Studies

“…In particular, prospective, longitudinal cross-diagnostic studies are needed to clarify the controversy. Some authors advocate for a multivariate approach that goes beyond the categorical distinction and uses dimensional information as a better way to understand the relationship between BPD and BD-II ( 89 ). Current diagnostic systems demonstrate a move toward dimensional rather than categorical approaches to classifying personality pathology and specially to consider personality traits in the management of all patients with BD irrespective of whether criteria for a categorical BPD are met ( 90 ).…”