DIFFERENTIAL DIAGNOSIS BETWEEN BIPOLAR MOOD DISORDER AND BORDERLINE PERSONALITY DISORDER: A SYSTEMATIC REVIEW

Abstract

Introduction: Bipolar mood disorder and borderline personality disorder are clinical conditions that are similar in terms of symptoms, making their differential diagnosis difficult and may imply inappropriate therapeutic indications. Therefore, to identify the distinction between the two disorders it is necessary to expand nosological knowledge about both. Aim: To gather scientific evidence that allows the operationalization of the differential diagnosis between bipolar disorder and borderline personality disorder. Methods: The systematic review followed the Preferred Reported Items for Systematic Review and Meta-analysis (PRISMA) recommendation. The search was carried out in Medical Subjects Online (Pubmed), Scientific Electronic Library Online (Scielo), Sci enceDirect in Portuguese and English. The project was registered in the PROSPERO system. The study consists of the evaluation of data and studies related to all scientific evidence regarding the specific question about the differences between borderline mood disorders and bipolarity or their concomitance. The variables used were socio demographic: age, gender. The main risk of the study is the misdiagnosis of patients. To reduce this bias, rigorous classification articles and studies were selected. Results: The research proved that there is difficulty in differentiating both disorders and, to re solve this problem, clinical and phenomenological criteria were exposed, although in isolation these are not sufficient for diagnosis. They took into account comorbidities and overlapping diagnoses that can be improved in psychiatry and general medical knowledge. Furthermore, concomitant traits are found between both illnesses. Con clusion: The doctor must recognize the etiological, genetic, clinical picture and treatment divergences of these diseases to establish that the presence of elevated mood, grandiosity, increased energy, speech pressure, decreased need for sleep, and hyperactivity are predominant characteristics for diagnosing Bipolar Affective Mood Disorder, while the presence of self-mutilation, suicidal attempts, suspiciousness and irritability are indicators of Borderline Personality Disorder.