Exploring early traumatic experiences as differential diagnostic factors between bipolar disorder and borderline...

Differential diagnosis between bipolar disorder (BD) and borderline personality disorder (BPD) presents significant challenges. Early traumatic experiences (ETE) are known to be associated with the development and prognosis of mental disorders in adulthood. This study aimed to characterize ETE that could serve as differentiating factors between BD and personality disorders as BPD.

This cross-sectional study included 90 patients diagnosed with BD (52 BD type I, 38 BD type II) and 50 patients diagnosed with personality disorders (35 BPD, 15 Other PD). Semi-structured interviews and evaluation of ETE using the ExpTra-S scale were conducted. Statistical analysis examined the characterization of ETE as potential differential marker between BD and BPD and diagnosis predictor.

Patients with BPD showed the highest prevalence of ETE. No significant differences in ExpTra-S factors were found among BD-I, BD-II, and other PD groups, but notable distinctions were observed between the BPD group and others. Sexual abuse emerged as the predominant type of ETE associated with the diagnosis of BPD, with a correct classification rate of 87 % within the sample.

Exclusion of comorbid cases restricts sample size and generalizability, while the retrospective assessment introduces recall bias. The lack of a control group hindered comparisons, and an uneven gender distribution may have introduced bias.

This study underscores the challenge of distinguishing between BD and BPD and emphasize the importance of assessing ETE, especially sexual abuse, in the differential diagnostic process between both conditions.