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Differentiating Between Bipolar Affective Disorder (Bd) and Borderline Personality Disorder (BPD) – a Clinical Case

Published online by Cambridge University Press:  23 March 2020

A. Ballesteros ,
A. Petcu ,
B. Cortés ,
L. Montes ,
F. Inchausti ,
W. Jaimes ,
J. Collantes  and
B. Zubizarreta
A. Ballesteros*
Affiliation:
Red de Salud Mental Gobierno de Navarra, Centro de Salud Mental Estella, Estella, Spain
A. Petcu
Affiliation:
Greater Manchester West Mental Health NHS Foundation Trust, psychiatry, Manchester, United Kingdom
B. Cortés
Affiliation:
Consultas Dr. B. Cortés, Psychiatry, Salamanca, Spain
L. Montes
Affiliation:
Red de Salud Mental Gobierno de Navarra, Complejo Hospitalario de Navarra, Pamplona, Spain
F. Inchausti
Affiliation:
Centro Proyecto Hombre, Comunidad terapéutica Proyecto Hombre de Estella, Estella, Spain
W. Jaimes
Affiliation:
Hospital de Donostia Osakidetza, Psiquiatría, Donostia, Spain
J. Collantes
Affiliation:
Consulta privada, Psicología, Madrid, Spain
B. Zubizarreta
Affiliation:
Red de Salud Mental Gobierno de Navarra, Centro de Salud Mental Estella, Estella, Spain
*
* Corresponding author.

Abstract

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Introduction

Recent studies suggest that Borderline Personality Disorder (BPD) could be regarded as an affective disorder within the Bipolar Affective Disorder (BP) spectrum. This is supported by evidence suggesting a clinical/neurobiological overlap between these two disorders. The Temperament and Character Inventory Revised (TCI-R) may help differentiate between the two disorders and orientate the clinical approach, considering the evidence of the medium-term temporal stability of TCI-R in a clinical population.

Objective

We present a clinical case diagnosed with BD which underwent testing using TCI-R. TCI-R orientated towards a secondary diagnosis of BPD and the case further received a course of Dialectical Behavior Therapy (DBT) which led to clinical improvement. We therefore study the usefulness of TCI-R in this clinical setting.

Aims

To study whether TCI-R may help differentiate between BD and BPD in mood stabilized patients.

Method

Our patient is a 52-year-old married male diagnosed with BD. Considering his clinical features of impulsivity/instability of behaviors and pathological interpersonal relationships, patient was started on individual DBT (fortnightly, 4 months). Psychotropic treatment (paroxetine 30 mg/day, lithium 1000 mg/day, aripiprazole 15 mg/day) was not modified.

Results

TCI-R scores: harm avoidance (100%), novelty seeking (53%), reward dependence (20%), persistence (18%), self-directedness (1%), cooperativeness (2%) and self-transcendence (48%). After 4 months of therapy, the patient improved in distress tolerance, acceptance, behavioral activation and assertiveness.

Conclusions

TCI-R is an inventory for personality traits in which character scores differ markedly between PD and non-PD patients. It is a useful tool in BPD patients orientating the clinician in the differential diagnosis and the treatment approach.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV869
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S504
Copyright
Copyright © European Psychiatric Association 2016
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