Borderline personality disorder and mood [1]

摘要

Parker examined whether borderline personality disorder (BPD) is a bipolar or unipolar mood condition and concluded by suggesting that it is probably neither. I would like to offer a supplementary interpretation of the literature; that is BPD is in large part a mood disorder but is not necessarily a bipolar or unipolar mood variant. Borderline personality disorder is highly comorbid with bipolar disorder and depression, and those who develop bipolar disorder have early temperamental markers of emotional dysregulation. Support that BPD is a mood disorder is also aligned with the fact that affective instability is a core feature of the syndrome. While under- investigated, there is emerging evidence that affect or mood instability, as opposed to mood episodes, might be the core feature of bipolar disorders. The majority of patients with established bipolar disorder, even after symptomatic control continue to experience daily or weekly mood swings. Further, the prevalence of mood instability and cyclothymic temperament is increased in unaffected bipolar probands and it predicts functioning in those with bipolar disorder. Mood instability is highly prevalent in unipolar depression and independently links to suicidality and health-service use. Furthermore in BPD, affective instability is the least stable of the 'trait-like' features of the syndrome over 2 years.