JFG has served on the advisory boards for Eli Lilly & Co. and GlaxoSmithKline; and serves on the speakers bureau for Abbott Laboratories, AstraZeneca, Eli Lilly & Co., GlaxoSmithKline, and Pfizer. JLG has no conflict of interest to disclose.
Age at onset of bipolar disorder and risk for comorbid borderline personality disorder
Article first published online: 25 FEB 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard
Volume 11, Issue 2, pages 205–208, March 2009
How to Cite
Goldberg, J. F. and Garno, J. L. (2009), Age at onset of bipolar disorder and risk for comorbid borderline personality disorder. Bipolar Disorders, 11: 205–208. doi: 10.1111/j.1399-5618.2008.00653.x
- Issue published online: 25 FEB 2009
- Article first published online: 25 FEB 2009
- Received 13 March 2008, revised and accepted for publication 23 May 2008
- age at onset;
- bipolar disorder;
- borderline personality disorder;
- childhood abuse;
Objectives: The relationship between bipolar disorder and cluster B personality disorders remains phenomenologically complex and controversial. We sought to examine the relationship between early age at onset of bipolar disorder and development of comorbid borderline personality disorder.
Methods: A total of 100 adults in an academic specialty clinic for bipolar disorder underwent structured diagnostic interviews and clinical assessments to determine lifetime presence of comorbid borderline personality disorder, histories of childhood trauma, and clinical illness characteristics.
Results: Logistic regression indicated that increasing age at onset of bipolar disorder was associated with a lower probability of developing comorbid borderline personality disorder (odds ratio = 0.91, 95% confidence interval: 0.83–0.99) while controlling for potential confounding factors, including a history of severe child trauma/abuse.
Conclusion: Early onset of bipolar disorder increases the probability of developing comorbid borderline personality disorder, independent of the effects of severe childhood trauma/abuse. In patients with borderline personality disorder, prospective studies of new-onset bipolar disorder may underestimate the prevalence of true comorbidity unless they capture the primary risk window for first-episode mania arising before the end of adolescence.