Personality Pathology Predicts Outcomes in a Treatment-Seeking Sample with Bipolar I Disorder

Abstract

We conducted a secondary analysis of data from a clinical trial to explore the relationship between degree of personality disorder (PD) pathology (i.e., number of subthreshold and threshold PD symptoms) and mood and functioning outcomes in Bipolar I Disorder (BD-I). Ninety-two participants completed baseline mood and functioning assessments and then underwent 4 months of treatment for an index manic, mixed, or depressed phase acute episode. Additional assessments occurred over a 28-month follow-up period. PD pathology did not predict psychosocial functioning or manic symptoms at 4 or 28 months. However, it did predict depressive symptoms at both timepoints, as well as percent time symptomatic. Clusters A and C pathology were most strongly associated with depression. Our findings fit with the literature highlighting the negative repercussions of PD pathology on a range of outcomes in mood disorders. This study builds upon previous research, which has largely focused on major depression and which has primarily taken a categorical approach to examining PD pathology in BD.

Predictors of long‐term work disability among patients with type I and II bipolar disorder: a prospective 18‐month follow‐up study

“…However, although Wenze et al. found that the degree of personality disorder pathology predicted depressive symptoms, they did not find an association with functional impairment. Loftus et al.…”

“…Studies have revealed that co-occurring personality disorder features in patients with BD predict a worse outcome (50). However, although Wenze et al (51) found that the degree of personality disorder pathology predicted depressive symptoms, they did not find an association with functional impairment. Loftus et al (52) also observed comorbid personality disorder to be associated with impaired functioning but this relationship was not independent of mood symptoms in multivariate analysis.…”