Depression in Patients with Borderline Personality Disorder

Background: the relevance of this research is determined by the challenges encountered in the differential diagnosis of Borderline Personality Disorder (BPD), the necessity to investigate the depressive syndrome in BPD to enhance comprehension of the disorder, and the pursuit of the most significant diagnostic criteria. The aim of the study was to investigate the depressive syndrome in patients with BPD as part of decompensation to improve differential diagnosis accuracy. Materials and Methods: 58 medical histories (74% women) analyzed. The average age of patients was 31.03 ± 1,87 years. ICD-10 diagnosis were F60.31 «Emotionally unstable personality disorder, borderline type» (n = 26), F33 «Recurrent depressive disorder» (n = 14), and F31 «Bipolar disorder» (n = 18) were examined. An archival method, including medical history, clinical interview, experimental psychological examination, was applied in the research. Results: depressive syndrome in BPD patients is characterized by ideas of self-deprecation, reduced self-esteem and self-confidence, and high levels of anxiety. According to the results of self-assessment, BPD patients noted the severity of depressive experiences: clinically pronounced depression was noted in more than half of cases, contrary to the results of objective assessment, where the mental state of patients’ majority corresponded to criteria of mild depression. A logistic regression model was developed that predicts with 96% efficiency the diagnosis of BPD in depressed patients based on ten predictors: controlling, unpredictable caregiver behavior, homo/bisexuality, chronic feelings of emptiness, unstable mood, ideas of guilt and self-deprecation, difficulty understanding feelings as measured by EPE, and average suicidal risk on the Suicide Risk Assessment Scale increase the likelihood of a BPD diagnosis. Symptoms such as substance use and anger outbursts are the most likely to increase the likelihood of diagnostic error, as they can lead to false positive diagnoses. Conclusion: clinical features of depression in BPD are significant for diagnosis and differential diagnostics.

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