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Differential diagnosis of bipolar and borderline personality disorders

Author(s): Joel Paris

The hypothesis that many mental disorders fall within a bipolar spectrum, and that the mood instability that characterizes borderline personality disorder puts it into this spectrum is critically reviewed. This conclusion is based on phenomenological resemblances, and does not consider differences in course, outcome and treatment. Careful evaluation of hypomania is required to diagnose bipolar II disorder. Affective instability is a different phenomenon that characterizes borderline personality disorder. Differential diagnosis is important because bipolar disorders require medication, while borderline personality disorder is most effectively managed with specialized forms of psychotherapy


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