People with borderline personality disorder (BPD) tend to suffer similar deterioration of their psychiatric and physical health as those with bipolar disorder, according to new research published in the British Journal of Psychiatry.
“Despite the clinical and public health significance of both of these disorders, it sometimes seems as if BPD lives in the shadow of bipolar disorder,” said researcher Mark Zimmerman, M.D., director of outpatient psychiatry at Rhode Island Hospital.
“Bipolar disorder is a widely researched, well-publicized, well-funded topic. By contrast, BPD is seldom discussed and it is not included in the Global Burden of Disease study, a comprehensive registry that quantifies diseases by cost, mortality, geography, risk, and other factors.”
About 1.6 percent of the U.S. population has been diagnosed with BPD, compared with 2.6 percent of those with bipolar disorder, according to the National Institute of Mental Health. The study is the largest comparison of patients who have been diagnosed with BPD or bipolar disorder.
“The level of psychosocial morbidity and suicidality associated with BPD is as great, or greater, than that experienced by patients with bipolar disorder,” said Zimmerman. “From a public health perspective, improving the detection and treatment of BPD is as imperative as diagnosing and treating bipolar disorders.”
People suffering from BPD have difficulty regulating emotions and thoughts, often tipping toward extremes. They engage in impulsive and reckless behavior, and their relationships with other people are typically unstable.
People with bipolar disorder often experience the same mood for weeks, while those with BPD deal with intense bouts of anger, depression and anxiety that are short in duration. According to the study, clinical experience suggests that BPD is just as debilitating as bipolar disorder. In fact, in psychiatric patient samples, BPD is as frequent as bipolar disorder.
Similar to patients with bipolar, those with BPD are more likely to suffer from depression, anxiety disorders, substance abuse, eating disorders, and suicidal behaviors. These other mental illnesses may have symptoms that overlap with BPD, making it difficult to recognize BPD in patients with these other mental illnesses.
This research was part of the MIDAS (Methods to Improve Diagnostic Assessment and Services) project, an ongoing clinical research study at Rhode Island Hospital. Their aim is to integrate research assessment methods into routine clinical practice.