Comorbidity bipolar disorder and personality disorders

Area of Science:

• Psychiatry
• Clinical Psychology

Background:

• Comorbidity with personality disorders is common in bipolar disorder (BD).
• Limited knowledge exists on managing BD patients with comorbid personality disorders.
• Personality disorders significantly impact the course and treatment of bipolar illness.

Purpose of the Study:

• To review the impact of personality disorder comorbidity on bipolar disorder outcomes.
• To synthesize current knowledge on managing comorbid BD and personality disorders.

Main Methods:

• Conducted comprehensive literature searches on PubMed (1970-2012).
• Keywords included "bipolar disorder" and "personality disorder" or "personality traits."
• Utilized cited references from relevant articles.

Main Results:

• Euthymic bipolar patients exhibit higher scores in harm avoidance, reward dependence, and novelty seeking compared to controls.
• Elevated novelty seeking in bipolar patients correlates with substance abuse comorbidity.
• Personality disorder comorbidity is linked to prolonged episodes, reduced euthymic periods, and earlier onset in BD.

Conclusions:

• Comorbidity with personality disorders worsens the course of bipolar illness, increasing episode duration and decreasing time in remission.
• Specific personality disorders like borderline and antisocial personality disorder exacerbate difficulties, including increased suicidality, aggression, and substance abuse.
• Impulsivity plays a role in the antisocial behaviors observed in patients with comorbid antisocial personality disorder.