Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals
Background and objectives: The quality of life and disease outcomes in bipolar patients, including increased risk of psychiatric hospitalizations and suicide, are adversely affected by the presence of borderline personality disorder (BPD). Our study aims to determine the impact of BPD on the inpatie...
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-01-01
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| Series: | Medicina |
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| Online Access: | http://www.mdpi.com/1010-660X/55/1/13 |
| _version_ | 1797727598902509568 |
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| author | Rikinkumar S. Patel Geetha Manikkara Amit Chopra |
| author_facet | Rikinkumar S. Patel Geetha Manikkara Amit Chopra |
| author_sort | Rikinkumar S. Patel |
| collection | DOAJ |
| description | Background and objectives: The quality of life and disease outcomes in bipolar patients, including increased risk of psychiatric hospitalizations and suicide, are adversely affected by the presence of borderline personality disorder (BPD). Our study aims to determine the impact of BPD on the inpatient outcomes of bipolar disorder patients. Methods: We used Nationwide Inpatient Sample from the US hospitals and identified cases with bipolar disorder and comorbid BPD (N = 268,232) and controls with bipolar disorder only (N = 242,379), using the International Classification of Diseases, 9th Revision, and Clinical Modification codes. We used multinomial logistic regression to generate odds ratios (OR) and evaluate inpatient outcomes. Results: The majority of the bipolar patients with BPD were female (84.2%), Caucasian (83.1%) and 18–35 years age (53.9%). Significantly longer inpatient stays, higher inpatient charges, and higher prevalence of drug abuse were noted in bipolar patients with BPD. The suicide risk was higher in bipolar patients with BPD (OR = 1.418; 95% CI 1.384–1.454; p <0.001). In addition, utilization of electroconvulsive treatment (ECT) was higher in bipolar patients with comorbid BPD (OR = 1.442; 95% CI 1.373–1.515; p <0.001). Conclusions: The presence of comorbid BPD in bipolar disorder is associated with higher acute inpatient care due to a longer inpatient stay and higher cost during hospitalization, and higher suicide risk, and utilization of ECT. Further studies in the inpatient setting are warranted to develop effective clinical strategies for optimal outcomes and reduction of suicide risk in bipolar patients with BPD. |
| first_indexed | 2024-03-12T11:01:59Z |
| format | Article |
| id | doaj.art-f1391297a7c4487ba7b9cd6de9797ac9 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T11:01:59Z |
| publishDate | 2019-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-f1391297a7c4487ba7b9cd6de9797ac92023-09-02T05:30:29ZengMDPI AGMedicina1010-660X2019-01-015511310.3390/medicina55010013medicina55010013Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US HospitalsRikinkumar S. Patel0Geetha Manikkara1Amit Chopra2Department of Psychiatry, Griffin Memorial Hospital, 900 E Main St, Norman, OK 73071, USADepartment of Psychiatry, Texas Tech University Health Science Center, Midland, TX 79701, USADepartment of Psychiatry, Allegheny Health Network, 4 Allegheny Center 8th Floor, Pittsburgh, PA 15212, USABackground and objectives: The quality of life and disease outcomes in bipolar patients, including increased risk of psychiatric hospitalizations and suicide, are adversely affected by the presence of borderline personality disorder (BPD). Our study aims to determine the impact of BPD on the inpatient outcomes of bipolar disorder patients. Methods: We used Nationwide Inpatient Sample from the US hospitals and identified cases with bipolar disorder and comorbid BPD (N = 268,232) and controls with bipolar disorder only (N = 242,379), using the International Classification of Diseases, 9th Revision, and Clinical Modification codes. We used multinomial logistic regression to generate odds ratios (OR) and evaluate inpatient outcomes. Results: The majority of the bipolar patients with BPD were female (84.2%), Caucasian (83.1%) and 18–35 years age (53.9%). Significantly longer inpatient stays, higher inpatient charges, and higher prevalence of drug abuse were noted in bipolar patients with BPD. The suicide risk was higher in bipolar patients with BPD (OR = 1.418; 95% CI 1.384–1.454; p <0.001). In addition, utilization of electroconvulsive treatment (ECT) was higher in bipolar patients with comorbid BPD (OR = 1.442; 95% CI 1.373–1.515; p <0.001). Conclusions: The presence of comorbid BPD in bipolar disorder is associated with higher acute inpatient care due to a longer inpatient stay and higher cost during hospitalization, and higher suicide risk, and utilization of ECT. Further studies in the inpatient setting are warranted to develop effective clinical strategies for optimal outcomes and reduction of suicide risk in bipolar patients with BPD.http://www.mdpi.com/1010-660X/55/1/13bipolar disorderborderline personality disorderpersonality disordercomorbidityinpatient psychiatrysuicidalmanagementhospital outcomesmood disordermanic episode |
| spellingShingle | Rikinkumar S. Patel Geetha Manikkara Amit Chopra Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals Medicina bipolar disorder borderline personality disorder personality disorder comorbidity inpatient psychiatry suicidal management hospital outcomes mood disorder manic episode |
| title | Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals |
| title_full | Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals |
| title_fullStr | Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals |
| title_full_unstemmed | Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals |
| title_short | Bipolar Disorder and Comorbid Borderline Personality Disorder: Patient Characteristics and Outcomes in US Hospitals |
| title_sort | bipolar disorder and comorbid borderline personality disorder patient characteristics and outcomes in us hospitals |
| topic | bipolar disorder borderline personality disorder personality disorder comorbidity inpatient psychiatry suicidal management hospital outcomes mood disorder manic episode |
| url | http://www.mdpi.com/1010-660X/55/1/13 |
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