Bipolar affective disorder and Borderline personality disorder: Differential diagnostic evaluation
DOI:
https://doi.org/10.33448/rsd-v14i5.48894Keywords:
Bipolar Disorder, Borderline Personality Disorder, Differential Diagnosis.Abstract
Introduction: Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) share clinical features such as emotional instability, impulsivity, and depressive episodes, making differential diagnosis challenging. This overlap may lead to inadequate treatments, increasing the risk of chronicity and functional impairment. Objective: This study aims to assess the main clinical and psychopathological distinctions between BD and BPD based on updated evidence, to improve differential diagnosis. Materials and Methods: An integrative literature review was conducted in indexed databases such as PubMed MEDLINE, SCIELO, Ebscohost, Google Scholar, and Virtual Health Library (VHL), using the descriptors "Bipolar Disorder," "Borderline Personality Disorder," and "Differential Diagnosis." Articles published between 2014 and 2024 were selected, prioritizing clinical studies, systematic reviews, and international guidelines. Data was critically analyzed, focusing on clinical presentation, diagnosis, and therapeutic strategies. Results and Discussion: The review demonstrated that well-defined mood episodes characterize BD, while BPD involves a persistent pattern of affective and interpersonal instability. Impulsivity and suicidal behavior are common in both disorders but appear more reactive and chronic in BPD. A family history of mood disorders and a positive response to mood stabilizers support the diagnosis of BD. Longitudinal assessment and the use of structured interviews are essential for accurate diagnosis. Conclusion: Differentiating BD and BPD is essential for effective therapeutic management. Understanding the clinical particularities of each disorder enables more targeted interventions and improves mental health outcomes.
Downloads
References
Arouca, M. E. D., da Fonseca Brito, M. N., Arouca, K. L. D., & de Souza, L. S. A. (2023). Diferenças e similaridades entre o transtorno de personalidade borderline e o transtorno afetivo bipolar. Revista Eletrônica Acervo Saúde, 23(6), e12575-e12575.
Bayes, A. J., & Parker, G. B. (2017). Clinical vs. DSM diagnosis of bipolar disorder, borderline personality disorder and their co‐occurrence. Acta Psychiatrica Scandinavica, 135(3), 259-265.
Bayes, A., Parker, G., & Fletcher, K. (2014). Clinical differentiation of bipolar II disorder from borderline personality disorder. Current opinion in psychiatry, 27(1), 14-20.
Bayes, A., Parker, G., & Paris, J. (2019). Differential diagnosis of bipolar II disorder and borderline personality disorder. Current psychiatry reports, 21, 1-11.
Bayes, A., Spoelma, M. J., Hadzi-Pavlovic, D., & Parker, G. (2021). Differentiation of bipolar disorder versus borderline personality disorder: A machine learning approach. Journal of Affective Disorders, 288, 68-73.
Camargos, B. R. de. (2024). Distinções entre transtorno de personalidade borderline e transtorno bipolar: Uma revisão de literatura (Trabalho de Conclusão de Curso). Universidade Federal de Santa Maria.
Cardoso, S. P., da Silva, J. N., & de Oliveira, J. C. (2024). Borderline, estigmas e perspectivas de intervenção: Uma revisão integrativa da literatura. Research, Society and Development, 13(12), e35131247603-e35131247603.
Durdurak, B. B., Altaweel, N., Upthegrove, R., & Marwaha, S. (2022). Understanding the development of bipolar disorder and borderline personality disorder in young people: a meta-review of systematic reviews. Psychological Medicine, 52(16), 3769-3782.
Gillett, G., McGowan, N. M., Palmius, N., Bilderbeck, A. C., Goodwin, G. M., & Saunders, K. E. (2021). Digital communication biomarkers of mood and diagnosis in borderline personality disorder, bipolar disorder, and healthy control populations. Frontiers in Psychiatry, 12, 610457.
Lopes, L. M., Matias, M., Marques, M., Lopes, I. M., & Reis, J. (2023). Bipolar Disorder and Borderline Personality Disorder: A Diagnostic Challenge. European Psychiatry, 66(S1), S701-S701.
MacDonald, L., & Sadek, J. (2023). Management strategies for borderline personality disorder and bipolar disorder comorbidities in adults with ADHD: a narrative review. Brain Sciences, 13(11), 1517.
Palmer, B. A., Pahwa, M., Geske, J. R., Kung, S., Nassan, M., Schak, K. M., ... & Singh, B. (2021). Self‐report screening instruments differentiate bipolar disorder and borderline personality disorder. Brain and behavior, 11(7), e02201.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Editora da UAB/NTE/UFSM. 10)
Reis, Y. D. S. B., de Oliveira Tertuliano, B., Cândido, C. R., Ramos, D. D. F. F., Mombelli, E. C., Torres, G. B., ... & de Brito Filho, I. G. (2023). Transtorno de Personalidade Borderline e suas apresentações clínicas. Brazilian Journal of Health Review, 6(6), 29386-29395.
Saccaro, L. F., Schilliger, Z., Dayer, A., Perroud, N., & Piguet, C. (2021). Inflammation, anxiety, and stress in bipolar disorder and borderline personality disorder: A narrative review. Neuroscience & Biobehavioral Reviews, 127, 184-192.
Santos, A. R. F., Tenisi, B. S., Dantas, J. M. M. L., Santana, M. L. C., dos Santos, R. C. M., & Dunningham, W. A. (2023). Diagnóstico diferencial entre transtorno do humor bipolar e transtorno de personalidade borderline: uma revisão sistemática. Revista Brasileira de Neurologia e Psiquiatria, 27(3).
Saunders, K. E. A., Bilderbeck, A. C., Price, J., & Goodwin, G. M. (2015). Distinguishing bipolar disorder from borderline personality disorder: A study of current clinical practice. European Psychiatry, 30(8), 965-974.
Scioli, K. (2021). Factors affecting clinicians’ decisions in differentiating borderline personality disorder and bipolar disorder (Doctoral dissertation, Indiana University of Pennsylvania).
Silveira, F. M. (2021). Comportamento impulsivo: A comorbidade transtorno de personalidade borderline e transtorno afetivo bipolar. COGNITIONIS Scientific Journal, 4(1), 1-16.
Souza, M. T. D., Silva, M. D. D., & Carvalho, R. D. (2010). Revisão integrativa: o que é e como fazer. Einstein (São Paulo), 8, 102-106.
Villarroel, J., Salinas, V., Silva, H., Herrera, L., Montes, C., Jerez, S., ... & Bustamante, M. L. (2020). Beyond the categorical distinction between borderline personality disorder and bipolar ii disorder through the identification of personality traits profiles. Frontiers in psychiatry, 11, 552.
Wright, L., Lari, L., Iazzetta, S., Saettoni, M., & Gragnani, A. (2022). Differential diagnosis of borderline personality disorder and bipolar disorder: Self‐concept, identity and self‐esteem. Clinical Psychology & Psychotherapy, 29(1), 26-61.
Zimmerman, M., Balling, C., Chelminski, I., & Dalrymple, K. (2021). Patients with borderline personality disorder and bipolar disorder: a descriptive and comparative study. Psychological medicine, 51(9), 1479-1490.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Maria Isabel Aparecida de Faria; Lara Quintella de Siqueira; Carolina Alves Corrêa; Ana Lídia Sousa de Souto; Josafá Jorge Pereira Filho
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
