본문 바로가기
KERD
논문KCI 등재

Borderline Personality Pathology in Major Depressive Disorder, Bipolar I and II Disorder, and Its Relationship With Childhood Trauma

강효신|원홍희|Lee Jong Hun|Yoon Joohyun|Myung Woojae|Yu Hyeona|Jang Yoonjeong|Lee Daseul|Park Yun Seong|Ihm Hong Kyu|Ryoo Hyun A|Cho Nayoung|Lee Jakyung|Kim Yeoju|Ha Tae Hyon|Park C. Hyung Keun|Park Ji Yoon|Lee Chan Woo|Oh Sunghee|You Ji Seon|Kwon Sarah Soonji|Lee Yeong Chan|Beak Ji Hyun
대한신경정신의학회 (Korean Neuropsychiatric Association)|2022.11|PSYCHIATRY INVESTIGATION|제19권 제11호|pp. 909-918|DOI 10.30773/pi.2022.0114

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

Mood disorderBipolar disorder.Emotional traumaAffective instability
주제분류정신과학

초록

Objective Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls.Methods A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory–Borderline Features Scale.Results BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients.Conclusion The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.

Abstract

Objective Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls.Methods A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory–Borderline Features Scale.Results BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients.Conclusion The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.

참고문헌 (54)

  1. Moffitt TE, "How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment", Psychol Med, 40, pp.899~909 (2010)
  2. McGlashan TH, "The borderline syndrome. II. Is it a variant of schizophrenia or affective disorder?", Arch Gen Psychiatry, 40, pp.1319~1323 (1983)
  3. Pope HG Jr, "The validity of DSM-III borderline personality disorder. A phenomenologic, family history, treatment response, and long-term follow-up study", Arch Gen Psychiatry, 40, pp.23~30 (1983)
  4. Frances A, "Reliability of criteria for borderline personality disorder: a comparison of DSM-III and the diagnostic interview for borderline patients", Am J Psychiatry, 141, pp.1080~1084 (1984)
  5. Perry JC, "Depression in borderline personality disorder: lifetime prevalence at interview and longitudinal course of symptoms", Am J Psychiatry, 142, pp.15~21 (1985)
  6. Zanarini MC, "Axis I comorbidity of borderline personality disorder", Am J Psychiatry, 155, pp.1733~1739 (1998)
  7. Chanen AM, "Integrating early intervention for borderline personality disorder and mood disorders", Harv Rev Psychiatry, 24, pp.330~341 (2016)
  8. Levenson JC, "The role of personality pathology in depression treatment outcome with psychotherapy and pharmacotherapy", J Consult Clin Psychol, 80, pp.719~729 (2012)
  9. Stringer B, "Recurrent suicide attempts in patients with depressive and anxiety disorders: the role of borderline personality traits", J Affect Disord, 151, pp.23~30 (2013)
  10. Grant BF, "Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions", J Clin Psychiatry, 69, pp.533~545 (2008)
  11. Hurt SW, "Borderline personality disorder: prototypic typology and the development of treatment manuals", Psychiatr Ann, 20, pp.13~18 (1990)
  12. Morey LC, "The personality assessment inventory professional manual" (1991), Psychological Assessment Resources
  13. Kernberg OF, "Borderline personality disorder, bipolar disorder, depression, attention deficit", hyperactivity disorder, and narcissistic personality disorder: practical differential diagnosis, 2013, pp.77, 1~22
  14. Ruggero CJ, "Borderline personality disorder and the misdiagnosis of bipolar disorder", J Psychiatr Res, 44, pp.405~408 (2010)
  15. Zeng R, "Assessing the contribution of borderline personality disorder and features to suicide risk in psychiatric inpatients with bipolar disorder, major depression and schizoaffective disorder", Psychiatry Res, 226, pp.361~367 (2015)
  16. Norman RE, "The longterm health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis", PLoS Med, 9, pp.e1001349~ (2012)
  17. Bremne JD, "Stress and development: behavioral and biological consequences", Dev Psychopathol, 13, pp.473~489 (2001)
  18. Mello MF, "Childhood maltreatment and adult psychopathology: pathways to hypothalamic-pituitary-adrenal axis dysfunction", Braz J Psychiatry, 31(Suppl 2), pp.S41~S48 (2009)
  19. The effects of childhood stress on health across the lifespan, "Middlebrooks JS", Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, ~ (2008)
  20. Cicchetti D, "Socioemotional, personality, and biological development:illustrations from a multilevel developmental psychopathology perspective on child maltreatment", Annu Rev Psychol, 67, pp.187~211 (2016)
  21. Zanarini MC, "Reported pathological childhood experiences associated with the development of borderline personality disorder", Am J Psychiatry, 154, pp.1101~1106 (1997)
  22. Lobbestael J, "Disentangling the relationship between different types of childhood maltreatment and personality disorders", J Pers Disord, 24, pp.285~295 (2010)
  23. Ibrahim J, "Childhood maltreatment and its link to borderline personality disorder features in children: a systematic review approach", Clin Child Psychol Psychiatry, 23, pp.57~76 (2018)
  24. Aaltonen KI, "Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients", Eur Psychiatry, 44, pp.53~60 (2017)
  25. Carr CP, "The role of early life stress in adult psychiatric disorders: a systematic review according to childhood trauma subtypes", J Nerv Ment Dis, 201, pp.1007~1020 (2013)
  26. Jaworska-Andryszewska P, "Childhood trauma in mood disorders: neurobiological mechanisms and implications for treatment", Pharmacol Rep, 71, pp.112~120 (2019)
  27. Güleç MY, "Effects of childhood trauma on somatization in major depressive disorder:the role of alexithymia", J Affect Disord, 146, pp.137~141 (2013)
  28. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Association
  29. Sheehan DV, "The Mini-International Neuropsychiatric Interview (M.I.N.I.):the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10", J Clin Psychiatry, 59(Suppl 20), pp.22~33 (1998)
  30. Bernstein DP, "Development and validation of a brief screening version of the childhood trauma questionnaire", Child Abuse Negl, 27, pp.169~190 (2003)
  31. Socada JL, "Presence and overlap of bipolar symptoms and borderline features during major depressive episodes", J Affect Disord, 280(Pt A), pp.467~477 (2021)
  32. Zimmerman M, "The relationship between borderline personality disorder and bipolar disorder", Dialogues Clin Neurosci, 15, pp.155~169 (2013)
  33. Paris J, "The interface between borderline personality disorder and bipolar spectrum disorders", Compr Psychiatry, 48, pp.145~154 (2007)
  34. Herman JL, "Childhood trauma in borderline personality disorder", Am J Psychiatry, 146, pp.490~495 (1989)
  35. Baryshnikov I, "Relationships between self-reported childhood traumatic experiences, attachment style, neuroticism and features of borderline personality disorders in patients with mood disorders", J Affect Disord, 210, pp.82~89 (2017)
  36. Cattane N, "Borderline personality disorder and childhood trauma: exploring the affected biological systems and mechanisms", BMC Psychiatry, 17, pp.221~ (2017)
  37. Martín-Blanco A, "Association between methylation of the glucocorticoid receptor gene, childhood maltreatment, and clinical severity in borderline personality disorder", J Psychiatr Res, 57, pp.34~40 (2014)
  38. Perroud N, "Methylation of serotonin receptor 3A in ADHD, borderline personality, and bipolar disorders: link with severity of the disorders and childhood maltreatment", Depress Anxiety, 33, pp.45~55 (2016)
  39. Dammann G, "Increased DNA methylation of neuropsychiatric genes occurs in borderline personality disorder", Epigenetics, 6, pp.1454~1462 (2011)
  40. Perroud N, "Response to psychotherapy in borderline personality disorder and methylation status of the BDNF gene", Transl Psychiatry, 3, pp.e207~ (2013)
  41. Thaler L, "Methylation of BDNF in women with bulimic eating syndromes:associations with childhood abuse and borderline personality disorder", Prog Neuropsychopharmacol Biol Psychiatry, 54, pp.43~49 (2014)
  42. Battle CL, "Childhood maltreatment associated with adult personality disorders:findings from the Collaborative Longitudinal Personality Disorders Study", J Pers Disord, 18, pp.193~211 (2004)
  43. Johnson JG, "Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: findings of a community-based longitudinal study", J Pers Disord, 14, pp.171~187 (2000)
  44. de Aquino Ferreira LF, "Borderline personality disorder and sexual abuse: a systematic review", Psychiatry Res, 262, pp.70~77 (2018)
  45. Pietrek C, "Neuromagnetic indication of dysfunctional emotion regulation in affective disorders", Depress Res Treat, 2012, pp.156529~ (2012)
  46. Goodman M, "The role of childhood trauma in differences in affective instability in those with personality disorders", CNS Spectr, 8, pp.763~770 (2003)
  47. Rogosch FA, "Child maltreatment, attention networks, and potential precursors to borderline personality disorder", Dev Psychopathol, 17, pp.1071~1089 (2005)
  48. Carlson MD, "Study design, precision, and validity in observational studies", J Palliat Med, 12, pp.77~82 (2009)
  49. Beck AT, "Cognitive therapy of personality disorders" (2015), Guilford Press
  50. Lu W, "Correlates of adverse childhood experiences among adults with severe mood disorders", Psychiatr Serv, 59, pp.1018~1026 (2008)
  51. Angst J, "Childhood adversity and chronicity of mood disorders", Eur Arch Psychiatry Clin Neurosci, 261, pp.21~27 (2011)
  52. Jaworska-Andryszewska P, "Childhood adversity and clinical features of bipolar mood disorder", Arch Psychiatry Psychother, 20, pp.13~19 (2018)
  53. Gratz KL, "Exploring the association between emotional abuse and childhood borderline personality features: the moderating role of personality traits", Behav Ther, 42, pp.493~508 (2011)
  54. Merza K, "The role of childhood traumatization in the development of borderline personality disorder in Hungary", Eur J Psychiatry, 29, pp.105~118 (2015)

관련 논문AI추천

Exploring the Correlation of Childhood Trauma With the Behavioral Activation and Inhibition System in Major Depressive Disorder and Bipolar I and II DisordersChan Woo Lee, Daseul Lee, Hong-Hee Won, Hyeona Yu, Hyuk Joon Lee, Hyun A Ryoo, Joohyun Yoon, Sarah Soonji Kwon, Tae Hyon Ha, Woojae Myung, Yejin Park, Yeong Chan Lee, Yoonjeong Jang, Yun Seong Park대한신경정신의학회 · PSYCHIATRY INVESTIGATION2025 · 제22권 제6호Comparative Study of Personality Traits in Patients with Bipolar I and II Disorder from the Five-Factor Model PerspectiveByungsu Kim, Jong-Han Lim, Seong Yoon Kim, Yeon Ho Joo대한신경정신의학회 · PSYCHIATRY INVESTIGATION2012 · 제9권 제4호Clinical Correlates of Alcohol Use Disorder in Depressed Patients with Unipolar and Bipolar Disorder명우재, Minseok Hong, Sunghee Oh, Suyeon Lee, Tae Hyon Ha대한신경정신의학회 · PSYCHIATRY INVESTIGATION2019 · 제16권 제12호Differences in Psychopathology between Offspring of Parents with Bipolar I Disorder and Those with Bipolar II Disorder: A Cross-Sectional StudyHyeon-Ah Lee, Ji Sun Kim, Nam-Hun Heo, Sehoon Shim, Yeon Jung Lee, Young Joon Kwon대한신경정신의학회 · PSYCHIATRY INVESTIGATION2018 · 제15권 제12호Cortical Volumetric Correlates of Childhood Trauma, Anxiety, and Impulsivity in Bipolar DisorderChon Myong-Wuk, Lee Dong-Kyun, Lee Hyeongrae, Lee Jung Hyun, Lee Wonhye, Park Dong Yeon, Ryu Vin, Song Hyehyun, Yu Rina대한신경정신의학회 · PSYCHIATRY INVESTIGATION2020 · 제17권 제7호The Relationship Between the Oxytocin Level and Rejection Sensitivity, Childhood Traumas, and Attachment Styles in Borderline Personality DisorderBurak Mete, Fatma Kartal, Kerim Uğur, Lut Tamam, Mehmet Emin Demirkol대한신경정신의학회 · PSYCHIATRY INVESTIGATION2022 · 제19권 제3호

이 간행물의 다른 논문 (10건)

Confounding by Indication in Studies of Selective Serotonin Reuptake InhibitorsLee Jimin, Chang Sung Manpp. 873-883Reliability and Validity of the Korean Version of Disruptive Behavior Disorders Rating Scale, DSM-5 Version-Parent FormJi Hyun Lee, Subin Park, Yunhye Oh, Eun Sol Lee, Vin Ryu, Jin Woong Yoon, Hyeree Han, Hyeon Hong, Hye Jung Son, Jungwon Choipp. 884-897Effect of Probiotic Adjuvant Therapy on Improvement of Clinical Symptoms & Interleukin 6 Levels in Patients With SchizophreniaBahar Burhanuddin, Lisal Sonny T., Aminuddin Aminuddin, Renaldi Rinvil, Mujahid Edy Husnul, Limoa Erlyn, Syamsuddin Saidahpp. 898-908COVID-19-Related Functional Impairment in a Community Sample of Korean Adults: Associations With Depression, COVID-19 Infection Fear, and ResilienceKim Moon-Doo, Jung Young-Eun, Park Yun-ju, Bahk Won-Myongpp. 919-926A Study on the Factors Affecting Anger in Patients With Post-traumatic Stress DisorderNamgung Seon, Lee Seung-Hoon, So Hyung Seok, Choi Jin Hee, Choi Hayun, Je Sungsuk, Kim Kiwonpp. 927-936
원문 보기