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Feature Article

Bipolar disorder, borderline personality disorder or both?

Philip M Boyce, Frances Wilson

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Abstract

Getting the diagnosis of bipolar disorder or borderline personality disorder right is important to ensure that patients receive the correct treatment for their condition and not a treatment that could potentially be harmful in the long term.

Key Points

  • Bipolar disorder is a recurrent mood disorder with generally good functioning between episodes. Mood stabilisers are the mainstay of treatment for patients with this condition.
  • Borderline personality disorder is a long-term disorder characterised by affective instability, with recurrent depressive episodes and chronically poor functioning. The mainstay of treatment for this condition is psychotherapeutic therapies.
  • The two conditions can be difficult to distinguish but accurate diagnosis is crucial to the patient receiving the most effective, evidence-based treatment.
  • The key to making the correct diagnosis is in careful history taking with attention paid to intermorbid functioning and family history.
  • Comorbidity of these conditions can occur and makes diagnosis and the effective delivery of treatment more difficult.

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