Importantly, preferential use of medication trials neglects
the psychosocial and behavior change interventions inherent in Entinostat in vitro treatments for BPD. More research is needed on to what degree these disorders benefit from various treatments relative to one another, and also on best treatment practices for comorbid BPD and bipolar disorder. An examination of comorbidity, and the specificity of the association, is informative regarding the link between BPD and the Inhibitors,research,lifescience,medical bipolar spectrum; however, the most informative approach towards answering this question is to compare depressed patients with and without BPD on validators that are specific for bipolar disorder.124 Thus, the demonstration Inhibitors,research,lifescience,medical that compared with depressed patients without BPD, depressed patients with BPD have more anxiety disorders, more substance-use disorders, and a younger age of onset, does not support the bipolar spectrum hypothesis because these differences would be expected for BPD as well. Instead, studies attempting to demonstrate that BPD is part of the bipolar spectrum should focus on variables that are specific to bipolar disorder such as a family Inhibitors,research,lifescience,medical history of bipolar disorder which would not be expected to be elevated in BPD probands unless BPD was part of the bipolar spectrum.
In the final analysis though we believe that the results of the present review challenge the notion that BPD is part of the bipolar Inhibitors,research,lifescience,medical spectrum. While the comorbidity rates are substantial, each disorder is nonetheless diagnosed in the absence of the other in the vast majority of cases (80% to 90%). In studies examining personality disorders broadly, other PDs such as histrionic and obsessive-compulsive were more Inhibitors,research,lifescience,medical commonly diagnosed in bipolar patients than was BPD. Although
not reviewed here, the converse is also true: other axis I disorders such as major depression, substance abuse, and post-traumatic stress disorder are also more commonly diagnosed before in patients with BPD than is bipolar disorder.115 In both of these cases, rates of comorbidity alone have not led to the argument that the disorders exist along the same spectrum. In valid cases of co-occurrence, it is possible that this reflects a common etiology where risk factors for one disorder lead to the co-occurrence of the other.125,126
In a survey of members of the International Society for the Study of Personality Disorders and the Association for Research on Personality Disorders, 80% of respondents indicated that “personality disorders are better understood as variants of normal personality than as categorical disease entities.
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