Can We Differentiate Borderline Personality Disorder from Bipolar Disorder?

Abstract

Distinguishing between borderline personality disorder and bipolar disorder is challenging due to symptom overlap. However, through careful screening and history-taking, collateral information from sources familiar with the patient, and the use of appropriate screening instruments, one may arrive at the correct diagnosis that will lead to optimal treatment planning. Clinicians must also recognize the possibility of the comorbidity of bipolar disorder and borderline personality disorder, and how such comorbidity may lead to poorer outcomes. This article reviews some of the key differences seen between borderline personality disorder and bipolar disorder in terms of neurobiology, heritability, longitudinal course, and subtle nuances in overlapping symptoms. [ Psychiatr Ann . 2020;50(1):19–23.]

Assessment of bipolar spectrum and personality disorders.

“…Factor analyses of pooled items from both scales yielded two factors, "anger-impulsivity" and "affective instability," which when combined accounted for the majority of symptom overlap between these cyclothymia and BPD respondents. Other investigations have similarly documented substantial symptom overlap between BPD and bipolar disorders (see Li et al, 2020, for a review).…”