How changes in depression severity and borderline personality disorder intensity are linked - a cohort study of depressed patients with and without borderline personality disorder.

IF 4 2区 医学 Q1 PSYCHIATRY
John J Söderholm, J Lumikukka Socada, Jesper Ekelund, Erkki Isometsä
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Abstract

Background: Borderline personality disorder (BPD) is often complicated by comorbid major depressive episodes (MDEs), which can occur as part of major depressive disorder (MDD) or bipolar disorder (BD). Such comorbidity is related to worse outcomes in both disorders. Subsyndromal features of BPD are also common in depression. However, studies of simultaneous changes in BPD and depression severities are scarce, and their interactions are poorly understood.

Aims: Studying the associations between changes in BPD and depression symptoms over the course of an MDE.

Methods: In a 6-month naturalistic cohort study of MDE/BPD, MDE/MDD, and MDE/BD patients (N = 95), we measured change in BPD features between baseline and six months with the Borderline Personality Disorder Severity Index (BPDSI), an interviewer-rated instrument quantifying recent temporal frequency of BPD symptoms. We examined changes in BPD severity and their correlation with depression severity and other clinical measures and compared these across patient groups.

Results: There were significant reductions in BPD severity, both in number of positive BPD criteria (-0.35, sd 1.38, p = 0.01672) and in BPDSI scores (-4.23, SD 6.74, p < 0.001), reflecting mainly a reduction in temporal frequency of symptoms. These were similar in all diagnostic groups. In multivariate regression models, changes in depression severity independently associated with changes in symptoms in the BDSI. This relationship was strongest in MDE/BPD patients but was not found in MDD patients without BPD.

Conclusions: In the six-month follow-up, BPD features in MDE patients alleviated mainly by decreasing temporal symptom frequency and intensity. In BPD patients with comorbid MDE, changes in both conditions are strongly correlated.

抑郁症严重程度的变化与边缘型人格障碍强度之间有何联系--对患有和未患有边缘型人格障碍的抑郁症患者进行的队列研究。
背景:边缘型人格障碍(BPD)常常因合并重度抑郁发作(MDE)而变得复杂,重度抑郁发作可能是重度抑郁障碍(MDD)或双相情感障碍(BD)的一部分。这种并发症与这两种疾病的不良预后有关。BPD 的亚症状特征在抑郁症中也很常见。然而,有关 BPD 和抑郁症严重程度同时发生变化的研究却很少,人们对它们之间的相互作用也知之甚少:在对 MDE/BPD、MDE/MDD 和 MDE/BD 患者(N = 95)进行的一项为期 6 个月的自然队列研究中,我们使用边缘型人格障碍严重程度指数(BPDSI)测量了基线和 6 个月之间 BPD 特征的变化。我们研究了 BPD 严重程度的变化及其与抑郁严重程度和其他临床指标的相关性,并对不同患者组进行了比较:结果:BPD 严重程度明显降低,无论是 BPD 阳性标准的数量(-0.35,SD 1.38,P = 0.01672)还是 BPDSI 评分(-4.23,SD 6.74,P 结论:BPDSI 评分与 BPD 阳性标准的数量(-0.35,SD 1.38,P = 0.01672)均呈正相关:在六个月的随访中,MDE 患者的 BPD 特征主要通过降低时间症状频率和强度而得到缓解。在合并 MDE 的 BPD 患者中,两种症状的变化密切相关。
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来源期刊
CiteScore
6.00
自引率
9.80%
发文量
30
审稿时长
28 weeks
期刊介绍: Borderline Personality Disorder and Emotion Dysregulation provides a platform for researchers and clinicians interested in borderline personality disorder (BPD) as a currently highly challenging psychiatric disorder. Emotion dysregulation is at the core of BPD but also stands on its own as a major pathological component of the underlying neurobiology of various other psychiatric disorders. The journal focuses on the psychological, social and neurobiological aspects of emotion dysregulation as well as epidemiology, phenomenology, pathophysiology, treatment, neurobiology, genetics, and animal models of BPD.
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