The Association of Bipolar Spectrum Disorders and Borderline Personality Disorder
The Association of Bipolar Spectrum Disorders and Borderline Personality Disorder
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DOI：
10.1007/s11126-012-9214-6
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发表时间：
2012-12-01
影响因子：
3.5
通讯作者：
Livaditis, Miltos
中科院分区：
文献类型：
--
作者：
Antoniadis, Diomidis;Samakouri, Maria;Livaditis, Miltos
双相情感障碍（BD）和边缘型人格障碍（BPD）是两种不同的实体，在许多领域具有各种共同特征，因此在鉴别诊断中存在困难。本文旨在探讨BD和BPD在发病机制、病因、病程和治疗方面的异同。对Pubmed（Medline）进行了系统性电子检索，以识别1990年至2010年期间发表的所有相关科学文章。BD和BPD的主要共同临床特征是情感不稳定和冲动，然而，每种疾病的质量存在差异。在神经解剖学领域，BD和BPD表现出相似之处，如边缘系统的改变，以及特定的差异，如BD中杏仁核大小的增加和BPD的减少。这两种疾病似乎都有很大比例的遗传性，但环境因素似乎在BPD中起着重要作用。BD和BPD都受到多巴胺能和多巴胺能系统改变的影响。BPD的功能和预后稍差。关于药物治疗，抗抑郁药被认为是有效的BPD，而情绪稳定剂是BD的主要治疗选择。各种心理治疗方法对这两种疾病的有效性仍在研究中。尽管在临床和生物学领域已经发现了相似之处和差异，但这两种疾病的关系尚未得到彻底定义。
Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) are two different entities sharing a variety of common features in a number of fields and, thus, presenting difficulties in their differential diagnosis. The aim of the review is to identify similarities and differences between BD and BPD concerning the symptomatology, causes, course and treatment of the two disorders. A systematic electronic search of Pubmed (Medline) was conducted in order to identify all relevant scientific articles published between 1990 and 2010. The main common clinical features of BD and BPD are affective instability and impulsivity, which, however, present with quality differences in each disorder. In the field of neuroanatomy, BD and BPD demonstrate similarities such as alterations in the limbic system, as well as specific differences, such as the increase in size of the amygdala in BD and the decrease in BPD. Both disorders appear to have a significant percentage of heritability, but environmental factors seem to hold an important role in BPD, in particular. Both BD and BPD are affected by alterations in the dopaminergic and serotonergic system. Fuctionability and prognosis are slightly worse for BPD. Concerning medication treatment, antidepressants are considered effective in BPD, whereas mood stabilizers are the main treatment of choice in BD. The effectiveness of a variety of psychotherapeutic methods is still under research for both disorders. Despite the similarities and differences already being traced in clinical and biological fields, the relationship of the two disorders has not yet been thoroughly defined.