Personality functioning in bipolar 1 disorder and borderline personality disorder

Area of Science:

• Psychiatry
• Clinical Psychology
• Personality Disorders

Background:

• Differentiating borderline personality disorder (BPD) from bipolar I disorder (BD) presents diagnostic challenges.
• Shared symptoms necessitate evaluation of personality functioning, self-identity, and interpersonal relations for accurate differential diagnosis.

Purpose of the Study:

• To empirically investigate and compare personality organization (PO), identity integration, and object relations in patients with BPD and BD.
• To identify key differences in personality functioning that aid in distinguishing between BPD and BD.

Main Methods:

• Utilized the Structured Interview of Personality Organization (STIPO) and Level of Personality Functioning Scale (LPFS).
• Assessed 34 BPD patients, 28 BD patients, and 27 healthy controls.
• Employed group comparisons and logistic regression to analyze differences.

Main Results:

• BPD patients showed significantly greater impairment in identity and aggression domains, with less impairment in moral values.
• The overall level of PO was significantly lower in the BPD group, even when excluding other personality disorders in the BD sample.
• Impaired personality structure severity impacted symptom load independently of the primary diagnosis (BPD or BD).

Conclusions:

• BPD is characterized by severe deficits in PO, whereas BD patients exhibit more variable PO levels.
• Greater impairment in personality functioning is evident in BPD compared to BD.
• Assessing PO is crucial for differential diagnosis and effective treatment planning in both BPD and BD.