Major Depression in Patients with Borderline Personality Disorder: A Clinical Investigation

Bellino, Silvio; Patria, Luca; Paradiso, Erika; Lorenzo, R. Di; Zanon, C; Zizza, M.; Bogetto, Filippo

doi:10.1177/070674370505000407

Cited by 43 publications

(26 citation statements)

References 30 publications

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“…The search period included coverage of the databases from 1980 (initial formulation of BPD criteria in DSM-III; APA, 1980) to February 05, 2014. Additionally, the references lists of relevant theoretical articles (Gunderson & Phillips, 1991;Rohde-Dachser, 2010;Silk, 2010) and recent empirical studies on depression experience in BPD (Bellino et al, 2005;Leichsenring, 2004;Levy et al, 2007;Stanley & Wilson, 2006) were examined. The titles and abstracts of publications were then screened for relevance and eligibility according to inclusion criteria.…”

Section: Search Strategymentioning

confidence: 99%

Quality and severity of depression in borderline personality disorder: A systematic review and meta-analysis

Köhling

Ehrenthal

Levy

et al. 2015

Clinical Psychology Review

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Section: Search Strategymentioning

confidence: 99%

Quality and severity of depression in borderline personality disorder: A systematic review and meta-analysis

Köhling

Ehrenthal

Levy

et al. 2015

Clinical Psychology Review

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“…7 Several studies have shown that BPD probands have a higher prevalence of affective disorders in their relatives compared to other personality disorders. 8–10 In addition, a multivariate twin study and significant longitudinal associations between BPD and depressive symptoms suggest that the relationship is due to a common latent factor. 11–13 Due to these shared characteristics, some researchers have proposed that chronic depression might be better conceptualized as a personality disorder and others believe that borderline personality is a variant of a mood disorder.…”

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confidence: 99%

The Relationship Between Borderline Personality Disorder and Major Depression in Later Life: Acute Versus Temperamental Symptoms

Galione

Oltmanns

2013

The American Journal of Geriatric Psychiatry

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Objective A recent issue in the personality disorder field is the prevalence and course of Axis II symptoms in later life. Focusing on the presentation of personality disorder criteria over time may have some utility in exploring the relationship between borderline personality disorder (BPD) and major depression in older adults. Temperamental personality symptoms are relatively resistant to change but tend to be nonspecific to disorders, while acute symptoms remit relatively quickly. We predicted that temperamental BPD symptoms would be positively correlated with a history of depression and did not expect to find a relationship between major depression and acute BPD symptoms. Method One thousand six hundred and thirty participants between the ages of 55 and 64 were recruited to participate in a community-based longitudinal study representative of the St. Louis area. Participants completed a battery of assessments at baseline, including diagnostic interviews for all ten personality disorders and major depressive disorder. Results Temperamental and acute BPD symptoms were significantly correlated with a history of major depression. After adjustments were made for the effects of temperamental symptoms on depression, acute symptoms were no longer correlated with a history of depression. As predicted, temperamental symptoms remained significantly related to depression, even after controlling for the effects of acute symptoms. BPD acute symptoms showed a unique negative correlation with the amount of time following remission from a depressive episode. Conclusions Overall, this study supports associations between major depression and borderline personality in older adults. The findings indicate that a history of major depression is primarily related to stable BPD symptoms related to emotional distress, which are more prevalent in older adults compared to acute features.

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“…Further, Cyranowski and others treated patients suffering from depression with IPT and found that subjects meeting criteria for a personality disorder more frequently needed adjunctive SSRI treatment to achieve remission of depressive episodes (16). Although this comorbidity is very common (53% to 85% in BPD samples) (27)(28)(29)(30)(31) and exerts significant effects on severity of depression and social impairment (27,32,33), there are currently no studies that focus on combined treatment of major depression that affects patients with BPD. The use of psychotherapy in treating these patients is central to the investigation of this topic.…”

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confidence: 99%

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

et al. 2006

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Objective: Combined treatment with psychotherapy and antidepressants is more effective than monotherapies. Recent data show that combined therapy has better results in patients with depression and Axis II codiagnosis. The aim of this study was to compare combined treatment using interpersonal psychotherapy (IPT) with pharmacotherapy alone in patients with depression and borderline personality disorder (BPD).Methods: There were 39 consecutive outpatients diagnosed with BPD who presented with a major depressive episode enrolled in this study. They were randomly assigned to 1 of 2 treatment groups: fluoxetine 20 mg to 40 mg daily or fluoxetine 20 mg to 40 mg daily plus IPT 1 session weekly. Owing to noncompliance, 7 patients dropped out. We assessed the 32 patients who completed the 24 weeks of treatment at baseline, Week 12, and Week 24, using a semistructured interview for clinical characteristics, the Clinical Global Impression Scale (CGI), the Hamilton Depression Rating Scale (HDRS), and the Hamilton Anxiety Rating Scale (HARS), and 2 self-report questionnaires, that is, the Satisfaction Profile (SAT-P) for quality of life and the 64-item Inventory for Interpersonal Problems (IIP-64). We performed statistical analysis, using univariate general linear models with 2 factors: duration and type of treatment.Results: Changes in remission rates, CGI, and HARS score did not differ between treatments. According to changes in the HDRS scores; changes in psychological functioning and social functioning scores on the SAT-P; and changes in vindictive or self-centred, cold or distant, intrusive or needy, and socially inhibited scores on the IIP-64, combined therapy was superior to fluoxetine alone. Conclusions:Combined therapy with IPT is more effective than antidepressant therapy alone, both in treating symptoms of major depression and in improving dimensions of quality of life and interpersonal functioning. Clinical implications· Combining fluoxetine and IPT is a more effective treatment of major depression symptoms in patients with BPD than fluoxetine alone. · Combined treatment produces more significant improvements in quality of life and interpersonal functioning in patients with BPD suffering from depression. · Combined therapy with fluoxetine and IPT can be considered a treatment of choice for major depression with BPD. Limitations· The sample size was relatively small; thus, conclusive statements cannot be made. · We did not compare combined therapy and IPT alone. · Follow-up data on recurrences of major depressive episodes have not yet been analyzed.

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Major Depression in Patients with Borderline Personality Disorder: A Clinical Investigation

Abstract: Patients with comorbid MDD and BPD present differential characteristics that indicate a more serious and impairing condition with a stronger familial link with mood disorders than is shown by depression patients with other Axis II codiagnoses.

Cited by 43 publications

References 30 publications

Quality and severity of depression in borderline personality disorder: A systematic review and meta-analysis

Quality and severity of depression in borderline personality disorder: A systematic review and meta-analysis

The Relationship Between Borderline Personality Disorder and Major Depression in Later Life: Acute Versus Temperamental Symptoms

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

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