Borderline personality disorder or bipolar disorder II? A literature review which goes beyond a categorical perspective
Brunetto De Sanctis, Niccolò Varrucciu, Marco Saettoni, Andrea Gragnani
Considering the overestimation of bipolar II diagnosis at the expense of borderline personality disorder,
and the consequent difficulty in accessing effective psychotherapeutic practice, the aim of this paper is
to identify traits considered as common in these disorders and to distinguish them in order to improve
diagnostic sensitivity. The confusion is explained by the diagnostic overshadowing between these
disorders; several studies have confirmed how affective instability and impulsive behaviour seem to be
appropriate traits to compare these two disorders.
For this purpose a revision of international literature from the last 15 years was carried out. Affectivity
shows differences in speed of change, interpersonal responsiveness, affective modulation and valence, for
borderline personality disorder from euthymic to anxiety, depression and anger whilst for bipolar disorder
II from euthymic to depression to elevation. Compared to impulsivity, borderline personality disorder and
bipolar disorder II differ in cognitive impulsivity (information processing speed); borderline personality
disorder reported a lack of premeditation (no consideration of consequences) and a lack of persistence
(problems remaining engaged in settings). Results will be discussed in the conclusion section.
Keywords
Borderline personality disorder, Bipolar disorder type II, Affective instability,
Impulsivity, Assessment.
