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Clinicians often attempt to differentiate bipolar disorder from borderline personality disorder (BPD) in adolescents. In a multisite study, 271 individuals with bipolar disorder I, II, or not otherwise specified were enrolled at average age 13 years and assessed longitudinally.
After age 18, participants were evaluated for personality disorder via structured interview; 12.2% met BPD criteria (BPD+). The BPD+ and BPD− groups did not differ in demographics, various concurrent psychiatric diagnoses, bipolar subtype, age of onset, or family histories of bipolar or substance use disorders. However, the BPD+ group had significantly higher baseline depression and self-reported anxiety and internalizing symptoms; more than half reported lifetime sui…