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Clinical differentiation of bipolar II disorder from borderline personality disorder

Bayes, Adam; Parker, Gordon; Fletcher, Kathryn

Current Opinion in Psychiatry: January 2014 - Volume 27 - Issue 1 - p 14–20
doi: 10.1097/YCO.0000000000000021
MOOD AND ANXIETY DISORDERS: Edited by Cornelius Katona and Gordon Parker

Purpose of review Differentiating bipolar II disorder (BP II) from borderline personality disorder (BPD) is a common diagnostic dilemma. The purpose of this review is to focus on recent studies that have considered clinical differences between the conditions including family history, phenomenology, longitudinal course, comorbidity and treatment response, and which might advance their clinical distinction.

Recent findings Findings suggest key differentiating parameters to include family history, onset pattern, clinical course, phenomenological profile of depressive and elevated mood states, and symptoms of emotional dysregulation. Less specific differentiation is provided by childhood trauma history, deliberate self-harm, comorbidity rates, neurocognitive features, treatment response and impulsivity parameters.

Summary This review refines candidate variables for differentiating BP II from BPD, and should assist the design of studies seeking to advance their phenomenological and clinical distinction.

School of Psychiatry, University of NSW, Sydney, Australia

Correspondence to Adam Bayes, Kiloh Unit, Prince of Wales Hospital, Randwick NSW 2031, Sydney, Australia. Tel: +61 2 9382 4352; fax: +61 2 9382 4399; e-mail: Adam.Bayes@SESIAHS.HEALTH.NSW.GOV.AU

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins