Conference paper
DYSPHORIA DIMENSIONS: A PRELIMINARY INPATIENTS STUDY TO DIFFRENTIATE BORDERLINE PERSONALITY AND BIPOLAR DISORDER SPECTRUM
Massimo C. Bachetti
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Francesca Brufani
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Giulio Spollon
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Patrizia Moretti
; Division of Psychiatry, Department of Medicine, University of Perugia, Perugia, Italy
Abstract
Background: Differentiating Borderline Personality Disorder (BPD) from Bipolar Disorder (BD) represents a very difficult
challenge for clinicians. Dysphoria could be a possible key to differentiate these disorders. We currently define dysphoria as a
complex and disorganized emotional state with proteiform phenomenology, characterized by a multitude of symptoms. Among them
irritability, discontent, interpersonal resentment and surrender prevail. These dimensions can be detected using the Neapen
Dysphoria Scale - Italian version (NDS-I). Dysphoria role in BPD has been highlighted by the recent theorization of the
Interpersonal Dysphoria Model, according to which dysphoria could represent the “psychopathological organizer” of the BPD. On
the other side, dysphoria role in BD has not yet been established. This is simply considered as an aspect, and not fundamental, of the
symptomatology characterizing BD, especially in mixed states patients. The phenomenological analysis of the dimensional spectrum
of dysphoria within BPD and DB could provide a valuable aid in the differential diagnosis between BPD and BD.
Aims: The aim of this paper is to verify if the dimensional spectrum of dysphoria differs between Borderline Personality
Disorder (BPD) and Bipolar Disorder Spectrum (BD) through an observational comparative study
Subjects and methods: In this study, 65 adult patients, males and females between the ages of 18 and 65, were enrolled from the
Psychiatric Service of the Santa Maria della Misericordia Hospital in Perugia (PG), Italy, from January 1st 2018 to April 30th 2019.
We have formed 2 groups. A BPD group composed of 33 patients (19 female patients, representing approximately 57.6 % of the
sample) and a BD group composed of 32 patients (18 Female patients, representing approximately 56.2% of the sample). Patient’s
comorbid with BD and BPD have been excluded from the study. After a preliminary assessment to exclude organic and psychiatric
comorbidity, and after at least 72 hours from hospitalization, we administered them the Neapen Dysphoria Scale - Italian Version
(NDS-I), a specific dimensional test for dysphoria. Starting from the dataset, with the aid of the statistical program SPSS 20, we have
carried out a comparison between disorders groups selected and their NDS-I total score and subscales (irritability, discontent,
interpersonal resentment, surrender); For this we have used the Mann-Whitney U test, a nonparametric test with 2 independent
samples, by setting a significance level p<0.05.
Conclusions: This study allowed us to explore and analyze dysphoria dimensions expressions in BPD and BD. Despite the small
sample analyzed, the results show a significant different dimensional spectrum expression of the dysphoria between the two disorders.
In particular, Irritability and Interpersonal Resentment dimensions show greater interest in BPD than BD spectrum. Further
studies with a larger and stratified sample are needed to confirm these results.
Keywords
dysphoria; borderline personality disorder; bipolar disorder; NDS-I; neapen dysphoria scale italian version
Hrčak ID:
264146
URI
Publication date:
4.9.2019.
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