Indicators of Clinical Severity in the Comorbidity of Bipolar Disorder and Borderline Personality Disorder: A Systematic Review

Valdivieso-Jiménez G.; Vásquez-Dextre E.; Barroilhet S.A. · Revista Colombiana de Psiquiatria (2025) · DOI: 10.1016/j.rcp.2023.08.002

Resumen

Introduction Bipolar disorder (BD) is a severe chronic mental health condition with significant morbidity and mortality. It is characterized by affective episodes of mania and depression, as well as mixed states. Borderline personality disorder (BPD) is characterized by emotional instability and a pattern of impulsive behavior associated with suicidality. Both diagnoses can be comorbid and present high dysfunction and severity. Methods The aim of this study was to describe the differential characteristics in terms of clinical severity, present in samples of patients with BD–BPD comorbidity versus samples of patients with only one of these diagnoses. A systematic review of the literature of cross-sectional, case–control and cohort studies was carried out in which samples of BD or BPD patients were compared with samples of BD–BPD comorbidity, published in English and Spanish, and that considered a population between 18 and 65 years old. Those studies that considered samples of patients with other comorbidities were excluded. Results A total of 12 studies were included, which included a total of 4246 patients of both sexes. The comorbidity of BD and BPD presented higher suicidality, depressive episodes and mania/hypomania, aggressiveness, anger and hostility, hospitalizations, worse functioning and greater severity of symptoms compared to those with a single diagnosis, especially BD. Conclusions The comorbidity of BD and BPD presents evidence of a greater impact on the clinical course compared to those who do not present this condition.

Instituciones: Universidad Nacional Mayor de San Marcos