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Distinguishing borderline personality disorder from bipolar disorder: differential diagnosis and implications [clinical conference]

1996; American Psychiatric Association; Volume: 153; Issue: 9 Linguagem: Inglês

10.1176/ajp.153.9.1202

1535-7228

Shay‐Lee Bolton, John G. Gunderson,

Psychotherapy Techniques and Applications

Iis often difficult to establish whether certain patients should he given the diagnosis of bipolar disorder, borderline personality disorder, or both. This case high- lights how knowledgeable psychi- atnists can have contrasting diag- nostic views about patients with volatile moods and impulsivity and how such disagreement can create problems in providing effective treatment. The patient described in this case report conceptualized her psychiatric problem as due to hipo- lan disorder, which she was told meant a biochemical illness charac- tenized by mood swings not under her control. She was told that this genetically determined disease could he stabilized by using the proper combination of medica- tions. This conceptualization of her illness sharply contrasted with the diagnosis developed during consul- tation-horderline personality dis- order. At that point the patient was told that she suffered from a psy- chiatnic disorder caused by devel- opmental difficulties that are best treated by psychosocial treatments, with psychopharmacology as an adjunctive treatment. With this di- agnosis she was expected to in- creasingly take responsibility for managing her mood swings and im-