Borderline personality disorder vs. mood disorders: clinical comparisons in young people treated within an “Early Intervention” service for first episode psychosis

• Lorenzo Pelizza ^[1] ; Emanuela Leuci ^[2] ; Emanuela Quattrone ^[2] ; Silvia Azzali ^[3] ; Giuseppina Paulillo ^[2] ; Simona Pupo ^[4] ; Pietro Pellegrini ^[2] ; Arianna Biancalani ^[5] ; Lorenzo Gammino ^[6] ; Marco Menchetti ^[7]
  1. [1] Department of Biomedical and Neuromotor Sciences, “Alma Mater Studiorum” Universita degli Studi di Bologna, Via Pepoli 5, 40123 Bologna, Italy; b Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100 Parma, Italy
  2. [2] Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli 1/a, 43100 Parma, Italy
  3. [3] Department of Mental Health and Pathological Addictions, Azienda USL-IRCCS di Reggio Emilia, Via Amendola 2, 43100 Reggio Emilia, Italy
  4. [4] Division of Pain Medicine, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100 Parma, Italy
  5. [5] Department of Biomedical and Neuromotor Sciences, “Alma Mater Studiorum” Universita degli Studi di Bologna, Via Pepoli 5, 40123 Bologna, Italy
  6. [6] Department of Mental Health and Pathological Addictions, Azienda USL di Bologna, Via Castiglione 29, 43124 Bologna, Italy
  7. [7] a Department of Biomedical and Neuromotor Sciences, “Alma Mater Studiorum” Universita degli Studi di Bologna, Via Pepoli 5, 40123 Bologna, Italy

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 37, Nº 4, 2023
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2023.07.002
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  • Background and Objective: Borderline Personality Disorder (BPD) is under-investigated in First Episode Psychosis (FEP). BPD psychotic manifestations and mood changes are also difficult to differentiate from first episode affective psychosis. The aim of this study was to compare sociodemographic and clinical features between FEP patients with BPD vs. Bipolar Disorder (BD) or Major Depressive Disorder (MDD) both at baseline and across a 2-year follow-up period.

    Methods: 224 FEP participants (49 with BPD, 93 with BD and 82 with MDD) completed the Health of the Nation Outcome Scale (HoNOS), the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) scale. Psychiatric diagnosis was reformulated at the end of our follow-up. Inter-group comparisons were analyzed using the Kruskal-Wallis or the Chisquare test. A mixed-design ANOVA model was also performed to assess the temporal stability of clinical scores within and between the 3 subgroups.

    Results: Compared to FEP/BD subjects at baseline, FEP/BPD patients showed higher depressive symptom severity and lower excitement severity. Compared to FEP/MDD at entry, they had a higher prevalence rate of substance abuse, a lower interpersonal impairment and a shorter DUP.

    Finally, they had a lower treatment response on HoNOS “Psychiatric Symptoms” subscale scores across the follow-up in comparison with both FEP/BD and FEP/MDD individuals.

    Conclusion: BPD as categorical entity represents a FEP subgroup with specific clinical features and treatment response. Appropriate treatment guidelines for this FEP subgroup are thus needed