The prevalence and predictors of bipolar and borderline personality disorders comorbidity: Systematic review and meta-analysis

Abstract Introduction Data about the prevalence of borderline personality (BPD) and bipolar (BD) disorders comorbidity are scarce and the boundaries remain controversial. We conducted a systematic review and meta-analysis investigating the prevalence of BPD in BD and BD in people with BPD. Methods T...

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Veröffentlicht in:Journal of affective disorders 2016-05, Vol.195, p.105-118
Hauptverfasser: Fornaro, M, Orsolini, L, Marini, S, De Berardis, D, Perna, G, Valchera, A, Ganança, L, Solmi, M, Veronese, N, Stubbs, B
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container_end_page 118
container_issue
container_start_page 105
container_title Journal of affective disorders
container_volume 195
creator Fornaro, M
Orsolini, L
Marini, S
De Berardis, D
Perna, G
Valchera, A
Ganança, L
Solmi, M
Veronese, N
Stubbs, B
description Abstract Introduction Data about the prevalence of borderline personality (BPD) and bipolar (BD) disorders comorbidity are scarce and the boundaries remain controversial. We conducted a systematic review and meta-analysis investigating the prevalence of BPD in BD and BD in people with BPD. Methods Two independent authors searched MEDLINE, Embase, PsycINFO and the Cochrane Library from inception till November 4, 2015. Articles reporting the prevalence of BPD and BD were included. A random effects meta-analysis and meta-regression were conducted. Results Overall, 42 papers were included: 28 considering BPD in BD and 14 considering BD in BPD. The trim and fill adjusted analysis demonstrated the prevalence of BPD among 5273 people with BD (39.94±11.78 years, 44% males) was 21.6% (95% CI 17.0–27.1). Higher comorbid BPD in BD were noted in BD II participants (37.7%, 95% CI 21.9–56.6, studies=6) and North American studies (26.2%, 95% CI 18.7–35.3, studies=11). Meta regression established that a higher percentage of males and higher mean age significantly (p
doi_str_mv 10.1016/j.jad.2016.01.040
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We conducted a systematic review and meta-analysis investigating the prevalence of BPD in BD and BD in people with BPD. Methods Two independent authors searched MEDLINE, Embase, PsycINFO and the Cochrane Library from inception till November 4, 2015. Articles reporting the prevalence of BPD and BD were included. A random effects meta-analysis and meta-regression were conducted. Results Overall, 42 papers were included: 28 considering BPD in BD and 14 considering BD in BPD. The trim and fill adjusted analysis demonstrated the prevalence of BPD among 5273 people with BD (39.94±11.78 years, 44% males) was 21.6% (95% CI 17.0–27.1). Higher comorbid BPD in BD were noted in BD II participants (37.7%, 95% CI 21.9–56.6, studies=6) and North American studies (26.2%, 95% CI 18.7–35.3, studies=11). Meta regression established that a higher percentage of males and higher mean age significantly (p&lt;0.05) predicted a lower prevalence of comorbid BPD in BD participants. The trim and fill adjusted prevalence of BD among 1814 people with BPD (32.22±7.35 years, 21.5% male) was 18.5% (95% CI 12.7–26.1). Limitations Paucity of longitudinal/control group studies and accurate treatment records. Conclusions BPD-BD comorbidity is common, with approximately one in five people experiencing a comorbid diagnosis. Based on current diagnostic constructs, and a critical interpretation of results, both qualitative and quantitative syntheses of the evidence prompt out the relevance of differences rather similarities between BD and BPD.</description><identifier>ISSN: 0165-0327</identifier><identifier>EISSN: 1573-2517</identifier><identifier>DOI: 10.1016/j.jad.2016.01.040</identifier><identifier>PMID: 26881339</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Bipolar disorder (BD) ; Bipolar Disorder - complications ; Bipolar Disorder - epidemiology ; Bipolar Disorder - psychology ; Borderline personality disorder (BPD) ; Borderline Personality Disorder - complications ; Borderline Personality Disorder - epidemiology ; Borderline Personality Disorder - psychology ; Comorbidity ; Humans ; Meta-analysis ; Predictors ; Prevalence ; Psychiatry ; Systematic review</subject><ispartof>Journal of affective disorders, 2016-05, Vol.195, p.105-118</ispartof><rights>Elsevier B.V.</rights><rights>2016 Elsevier B.V.</rights><rights>Copyright © 2016 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-2850e3c43403bc1f80a4a5f143eb0b965218240d4d6596fab200e3ac029a7b7d3</citedby><cites>FETCH-LOGICAL-c507t-2850e3c43403bc1f80a4a5f143eb0b965218240d4d6596fab200e3ac029a7b7d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S016503271531291X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26881339$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fornaro, M</creatorcontrib><creatorcontrib>Orsolini, L</creatorcontrib><creatorcontrib>Marini, S</creatorcontrib><creatorcontrib>De Berardis, D</creatorcontrib><creatorcontrib>Perna, G</creatorcontrib><creatorcontrib>Valchera, A</creatorcontrib><creatorcontrib>Ganança, L</creatorcontrib><creatorcontrib>Solmi, M</creatorcontrib><creatorcontrib>Veronese, N</creatorcontrib><creatorcontrib>Stubbs, B</creatorcontrib><title>The prevalence and predictors of bipolar and borderline personality disorders comorbidity: Systematic review and meta-analysis</title><title>Journal of affective disorders</title><addtitle>J Affect Disord</addtitle><description>Abstract Introduction Data about the prevalence of borderline personality (BPD) and bipolar (BD) disorders comorbidity are scarce and the boundaries remain controversial. We conducted a systematic review and meta-analysis investigating the prevalence of BPD in BD and BD in people with BPD. Methods Two independent authors searched MEDLINE, Embase, PsycINFO and the Cochrane Library from inception till November 4, 2015. Articles reporting the prevalence of BPD and BD were included. A random effects meta-analysis and meta-regression were conducted. Results Overall, 42 papers were included: 28 considering BPD in BD and 14 considering BD in BPD. The trim and fill adjusted analysis demonstrated the prevalence of BPD among 5273 people with BD (39.94±11.78 years, 44% males) was 21.6% (95% CI 17.0–27.1). Higher comorbid BPD in BD were noted in BD II participants (37.7%, 95% CI 21.9–56.6, studies=6) and North American studies (26.2%, 95% CI 18.7–35.3, studies=11). Meta regression established that a higher percentage of males and higher mean age significantly (p&lt;0.05) predicted a lower prevalence of comorbid BPD in BD participants. The trim and fill adjusted prevalence of BD among 1814 people with BPD (32.22±7.35 years, 21.5% male) was 18.5% (95% CI 12.7–26.1). Limitations Paucity of longitudinal/control group studies and accurate treatment records. Conclusions BPD-BD comorbidity is common, with approximately one in five people experiencing a comorbid diagnosis. Based on current diagnostic constructs, and a critical interpretation of results, both qualitative and quantitative syntheses of the evidence prompt out the relevance of differences rather similarities between BD and BPD.</description><subject>Bipolar disorder (BD)</subject><subject>Bipolar Disorder - complications</subject><subject>Bipolar Disorder - epidemiology</subject><subject>Bipolar Disorder - psychology</subject><subject>Borderline personality disorder (BPD)</subject><subject>Borderline Personality Disorder - complications</subject><subject>Borderline Personality Disorder - epidemiology</subject><subject>Borderline Personality Disorder - psychology</subject><subject>Comorbidity</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>Predictors</subject><subject>Prevalence</subject><subject>Psychiatry</subject><subject>Systematic review</subject><issn>0165-0327</issn><issn>1573-2517</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUkuL1TAYDaI416s_wI106ab1y6tpFYRh8AUDLmYEdyFNvmJq21yTXqUbf7vpvaMLF-Iqj_MIOecj5CmFigKtXwzVYFzF8rYCWoGAe2RHpeIlk1TdJ7sMyBI4UxfkUUoDANStgofkgtVNQzlvd-Tn7RcsDhG_mxFni4WZ3XZ03i4hpiL0RecPYTTxhHQhOoyjn7MGYwqzGf2yFs6nE5AKG6YQO-_y7cviZk0LTmbxtsgPePxx8phwMaXJyjX59Jg86M2Y8Mnduief3r65vXpfXn989-Hq8rq0EtRSskYCciu4AN5Z2jdghJE9FRw76NpaMtowAU64WrZ1bzoGmW8ssNaoTjm-J8_PvocYvh0xLXryyeI4mhnDMWmqWmiloFz8B1VBTk_m_PaEnqk2hpQi9voQ_WTiqinorSE96NyQ3hrSQHVuKGue3dkfuwndH8XvSjLh1ZmAOY-cWtTJ-q0b5yPaRbvg_2n_-i-1zXV5a8avuGIawjHm6PMvdGIa9M02ItuEUMkpa-ln_gtoTbd_</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Fornaro, M</creator><creator>Orsolini, L</creator><creator>Marini, S</creator><creator>De Berardis, D</creator><creator>Perna, G</creator><creator>Valchera, A</creator><creator>Ganança, L</creator><creator>Solmi, M</creator><creator>Veronese, N</creator><creator>Stubbs, B</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20160501</creationdate><title>The prevalence and predictors of bipolar and borderline personality disorders comorbidity: Systematic review and meta-analysis</title><author>Fornaro, M ; Orsolini, L ; Marini, S ; De Berardis, D ; Perna, G ; Valchera, A ; Ganança, L ; Solmi, M ; Veronese, N ; Stubbs, B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-2850e3c43403bc1f80a4a5f143eb0b965218240d4d6596fab200e3ac029a7b7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Bipolar disorder (BD)</topic><topic>Bipolar Disorder - complications</topic><topic>Bipolar Disorder - epidemiology</topic><topic>Bipolar Disorder - psychology</topic><topic>Borderline personality disorder (BPD)</topic><topic>Borderline Personality Disorder - complications</topic><topic>Borderline Personality Disorder - epidemiology</topic><topic>Borderline Personality Disorder - psychology</topic><topic>Comorbidity</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>Predictors</topic><topic>Prevalence</topic><topic>Psychiatry</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fornaro, M</creatorcontrib><creatorcontrib>Orsolini, L</creatorcontrib><creatorcontrib>Marini, S</creatorcontrib><creatorcontrib>De Berardis, D</creatorcontrib><creatorcontrib>Perna, G</creatorcontrib><creatorcontrib>Valchera, A</creatorcontrib><creatorcontrib>Ganança, L</creatorcontrib><creatorcontrib>Solmi, M</creatorcontrib><creatorcontrib>Veronese, N</creatorcontrib><creatorcontrib>Stubbs, B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Journal of affective disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fornaro, M</au><au>Orsolini, L</au><au>Marini, S</au><au>De Berardis, D</au><au>Perna, G</au><au>Valchera, A</au><au>Ganança, L</au><au>Solmi, M</au><au>Veronese, N</au><au>Stubbs, B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prevalence and predictors of bipolar and borderline personality disorders comorbidity: Systematic review and meta-analysis</atitle><jtitle>Journal of affective disorders</jtitle><addtitle>J Affect Disord</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>195</volume><spage>105</spage><epage>118</epage><pages>105-118</pages><issn>0165-0327</issn><eissn>1573-2517</eissn><abstract>Abstract Introduction Data about the prevalence of borderline personality (BPD) and bipolar (BD) disorders comorbidity are scarce and the boundaries remain controversial. We conducted a systematic review and meta-analysis investigating the prevalence of BPD in BD and BD in people with BPD. Methods Two independent authors searched MEDLINE, Embase, PsycINFO and the Cochrane Library from inception till November 4, 2015. Articles reporting the prevalence of BPD and BD were included. A random effects meta-analysis and meta-regression were conducted. Results Overall, 42 papers were included: 28 considering BPD in BD and 14 considering BD in BPD. The trim and fill adjusted analysis demonstrated the prevalence of BPD among 5273 people with BD (39.94±11.78 years, 44% males) was 21.6% (95% CI 17.0–27.1). Higher comorbid BPD in BD were noted in BD II participants (37.7%, 95% CI 21.9–56.6, studies=6) and North American studies (26.2%, 95% CI 18.7–35.3, studies=11). Meta regression established that a higher percentage of males and higher mean age significantly (p&lt;0.05) predicted a lower prevalence of comorbid BPD in BD participants. 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subjects Bipolar disorder (BD)
Bipolar Disorder - complications
Bipolar Disorder - epidemiology
Bipolar Disorder - psychology
Borderline personality disorder (BPD)
Borderline Personality Disorder - complications
Borderline Personality Disorder - epidemiology
Borderline Personality Disorder - psychology
Comorbidity
Humans
Meta-analysis
Predictors
Prevalence
Psychiatry
Systematic review
title The prevalence and predictors of bipolar and borderline personality disorders comorbidity: Systematic review and meta-analysis
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