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Axis II Comorbidities in BD: Mood State Matters

Bipolar Disord; ePub 2018 Jan 25; Post, et al

A wide range of personality disorders occur in patients with bipolar disorder (BD), according to a recent study, but this is highly dependent on whether patients are filling out the Personality Disorder Questionnaire, 4th edition, (PDQ4) while depressed as compared to those who are euthymic. 966 outpatients gave informed consent and filled out the PDQ4 and a questionnaire on demographics and course of illness prior to Bipolar Treatment Outcome Network entry, at the average age of 41 years. Patients were rated at each visit for depression on the Inventory of Depressive Symptoms-Clinician version (IDS-C) and for mania on the Young Mania Rating Scale (YMRS). Researchers found:

  • Patients met criteria for most personality disorders at a much higher rate when they took the PDQ4 while depressed compared to while euthymic, and scores were significantly related to the severity of depression (IDS) and of mania (YMRS) assessed within 2 weeks of taking the PDQ.
  • Even when euthymic, more than quarter to half of the patients met criteria for a cluster A, B, or C personality disorder.

Post RM, Leverich GS, McElroy, et al. Prevalence of axis II comorbidities in bipolar disorder: Relationship to mood state. [Published online ahead of print January 25, 2018]. Bipolar Disord. doi:10.1111/bdi.12596.