Borderline features in Youth with Bipolar Spectrum Disorders

Background/Objectives: Differentiating bipolar disorder (BD) from a borderline personality disorder (BPD) can be diagnostically challenging as symptoms such as, depression, aggression and interpersonal relationships are common to both conditions. Identifying related and unrelated items between BD and BPD may improve diagnostic accuracy since both diagnoses have varying treatments which can be implemented before a behavioral emergency occurs. This study sought to determine which features of BPD, as assessed by the Borderline Personality Features Scale-Child (BPFS-C), are related to BD in youth diagnosed with BD. Methods: Thirty participants (M: 16, F: 14), with BD, aged 7-17 years (mean +/- standard deviation, 12.95 +/- 3.08 years) met DSM-V criteria for BD I (n=20) and BD II (n=3). The Course and Outcome of Bipolar Youth criteria was used to establish the BD-Not Otherwise Specified diagnosis (n=7). The 24-item self-report BPFS-C was administered to the youth. Two-tailed Pearson correlations were performed to assess associations between scores on the BPFS-C with scores on various psychopathology-related predictor variables while adjusting for age, race and primary BD diagnosis. Results: Higher BPFS-child scores positively correlated with child scores of more severe depression, self-injurious behaviors, and increased impulsive aggression. Conclusion: BPFS-child scores may assist clinicians in identifying youth with BD who may be on the trajectory to developing BPD and thus, implementing targeted psychotherapeutic interventions.