Comparing Neurocognitive Profile of Patients with Borderline Personality and Bipolar-II Disorders
,
Abstract
Objective: The present study was conducted to compare neurocognitive profile in patients with borderline personality disorder (BPD) and bipolar II disorder (BD-II) and to find whether BPD can be classified as one of bipolar spectrum disorders.
Method: A total of 35 patients with BPD and 35 euthymic patients with BDII disorder were selected by convenience sampling method. These 2 groups were compared with 30 healthy individuals using neurocognitive battery tests that assessed cognitive flexibility and set-shifting, response inhibition, problem-solving, decision-making, and sustained and selective attention. Data were analyzed using independent t test, X2 and ANOVA.
Results: Patients with euthymic BDII and BPD had poorer performance than the healthy group in most neurocognitive domains (p<0.05). Both patient groups showed similar functions in cognitive flexibility and set-shifting, decision-making, sustained and selective attention, and problem-solving (p<0.05). BPD patients had more elevated response inhibition deficits than BD-II patients (P<0.05). Also, BPD patients had poorer performance in planning compared to BD-II patients (P<0.05).
Conclusion: The results provided empirical support for previous findings which have reported that patients with BPD and BD-II show neurocognitive dysfunctions. Despite the similarity between these 2 clinical groups in terms of neurocognitive profile in this study, more extensive studies are needed to confirm the hypothesis that BPD can be conceptualized as one of bipolar spectrum disorders.
Magill A. The Boundary between borderline personality disorder and bipolar disorder: Current Concepts and Challenges. Can J Psychiatry. 2004; 49: 551-556.
Reich D B, Zanarini MC. Affective lability in bipolar disorder and borderline personality disorder: Compr Psychiatry, 2012; 53: 230–237.
Mackinnon DF, Pies R. Affective instability as rapid cycling: theoretical and clinical implications for borderline personality and bipolar spectrum disorders. Bipolar Disord. 2006;8:1-14
Zimmerman M, Morgan TA. The relationship between borderline personality disorder and bipolar disorder. Dialogues Clin Neurosci. 2013; 15(2): 155-69
Frias A, Baltasar I, Birmaher B. Comorbidity between bipolar disorder and borderline personality disorder: Prevalence, explanatory theories, and clinical impact. J Affective Disorder. 2016; 15: 202:210-9.
Belli H, Ural C, Akbudak M J. Borderline personality disorder: bipolarity, mood stabilizers and atypical antipsychotics in treatment. Clin Med Res. 2012; 4(5):301-8.
Smith DJ, Muir WJ, Blackwood DH. Is borderline personality disorder part of the bipolar spectrum? Harv Rev Psychiatry. 2004; 12(3):133-9.
Akiskal HS .Demystifying Borderline personality disorder: critique of the concept and unorthodox reflections on its natural kinship with the bipolar spectrum. Acta Psychiatr Scand 2004; 110:401-7.
Wilson ST, Stanley B, Oquendo MA, Goldberg P, Zalsman G, and Mann JJ: Comparing impulsiveness, hostility, and depression in borderline personality disorder and Bipolar II disorder. J Clin Psychiatry. 2007; 68:1533–1539.
Reich DB, Zanarini MC, Hopwood CJ, Thomas KM, Fitzmaurice GM. Comparison of affective instability in borderline personality disorder and bipolar disorder using a self-report measure. Personal Ment Health. 2014; 8(2): 143-150.
Benazzi F. Borderline personality-bipolar spectrum relationship. Prog Neuropsychopharmacol Biol Psychiatry. 2006; 30:68–74.
Perugi, G., Toni, C., Travierso MC, Akiskal HC. The role of cyclothymia in atypical depression: toward a data-based reconceptualization of the borderline-bipolar II connection. J Affective Disorder. 2003, 73(1-2), 87-98.
Quraishi S, Frangou S. Neuropsychology of bipolar disorder: a review. J Affect. Disord. 2002; 72: 209–226.
Kurtz MM, Gerraty RT. A meta-analytic investigation of neurocognitive deficits in bipolar illness: profile and effects of clinical state. Neuropsychology. 2009 ; 23 :551-62.
Palsson E, Figueras C, Johansson A, GM, Ekman CJ, Hultman B, Ostlind J, Landen M. Neurocognitive function in bipolar disorder: a comparison between bipolar I and II disorder and matched controls. BMC Psychiatry. 2013; 13: 165 DOI: 10.1186/1471-244X-13-165.
Dickinson T, Becerra R, Coombes J. Executive functioning deficits among adults with Bipolar Disorder (types I and II): A systematic review and meta-analysis. J of affective Disord. 2017; 29: 218-427.
Dinn, WM, Harris CL, Aycicegi A, Greene PB, Kirkley SM, Reilly C Neurocognitive function in borderline personality disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2004; 28(2):329-41.
Arza R, Díaz-Marsá M, López-Micó C, Fernández de Pablo N, López-Ibor II, Carrasco JL. Neuropsychological dysfunctions in personality borderline disorder: detection strategies. Actas Esp Psiquiatr 2009; 37(4):185-190.
Black DW, Forbush KT, Langer A, Shaw M, Graeber MA, Moser DJ, Bayless J, Watson D, Hovick L, Meyer V, Blum N. The neuropsychology of borderline personality disorder: A preliminary study on the predictive variance of neuropsychological tests vs. personality trait dimensions. Personal Ment Health. 2009; 3(2). 128-141.
Schuermann B, Kathmann N, Stiglmayr C, et al. Impaired decision making and feedback evaluation in borderline personality disorder. Psychol Med. 2011; 41:1917–1927.
Sripada CH, Silk KR.The role of functional neuroimaging in exploring the overlap between borderline personality disorder and bipolar disorder. Curr Psychiatry Rep. 2007; 9(1): 40-45.
First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders. New York Psychiatric Insititue, New York.1995.
First MB, Spitzer RL, Gibbon M, Williams JB. The structured clinical interview for DSM-III-R personality disorders (SCID-II). Part I: description. J Pers Disord 1995;9(2):83–91.
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry.1960; 23:56-62.
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978; 133:429-435.
Heaton R .Wisconsin Card Sorting Test. Odessa, FL: Psychological Assesment Resources, Inc. 1981.
Bechara A, Damasio AR, Damasio H, Anderson SW: Insensitivity to future consequences following damage to human prefrontal cortex. Cognition. 1994; 50: 7-15.
Golden CJ. Stroop Color and Word Test. Chicago, Ill: Stoelting; 1978.
Krikorian R, Bartok J, Gay N. Tower of London procedure: a standard method and developmental data. J Clin Exp Neuropsychol. 1991; 16(6): 840–850.
Rosvold HE, Mirsky AF, Sarason I, Bransome ED, Beck LH. A continuous performance test of brain damage. J Consult Clin Psychol. 1956; 20: 343-350.
Wechsler D. Wechsler Adult Intelligence Scale. Cleveland, Ohio: The Psychological Corporation; 1955.
Bourne C, Aydemir O¨, Balanza´ -Martı´nez V, Bora E, Brissos S, Cavanagh J, et al. Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis. Acta Psychiatr Scand. 2013; 128:149–62.
Mann–Wrobel MC, Carreno JT, Dickinson D. Meta–analysis of neuropsychological functioning in euthymic bipolar disorder: an update and investigation of moderator variables. Bipolar Disord. 2011; 13: 334–342.
Ruocco AC. The neuropsychology of borderline personality disorder: A meta-analysis and review. Psychiatry Res. 2005; 137: 191–202.
Henry C, Mitropoulou V, New AS, Koenigsberg HW, Silverman J, Siever LJ. Affective instability and impulsivity in borderline personality and bipolar II disorders: similarities and differences. J Psychiatr Res. 2001; 35(6): 307-312.
Gvirts HZ, Braw Y, Harari H, Lozin M, Bloch Y, Fefer K, Levkovitz Y. Executive dysfunction in bipolar disorder and borderline personality disorder. Eur Addict Res 2015; 30: 959–964.
Beblo T, Driessen M, Mertens M, Wingenfeld K, Piefke M, Rullkoetter N, Rau H. Functional MRI correlates of the recall of unresolved life events in borderline personality disorder. Psychol Med.2006; 36(06): 845-856.
Bustamante M L, Villarroel J, Francesetti V, Ríos M, Arcos-Burgos M, Jerez S, Silva, H. Planning in borderline personality disorder: Evidence for distinct subpopulations. World J Biol Psychiatry. 2009; 10(4-2): 512-517.
Arts B, Simons CJ, Drukker M, Van OS J. Antipsychotic medications and cognitive functioning in bipolar disorder: moderating effects of COMT Val108/158 Met genotype. BMC Psychiatry. 2013; 19: 13-63.
| Files | ||
| Issue | Vol 14 No 2 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v14i2.990 | |
| Keywords | ||
| Bipolar Disorder Borderline Personality Disorder Neurocognitive Profile | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
