Borderline personality disorder vs. schizophrenia spectrum disorders in young people recruited within an "Early Intervention in Psychosis" service: clinical and outcome comparisons.

Journal: European archives of psychiatry and clinical neuroscience

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Affiliated Institutions:  Department of Biomedical and Neuromotor Sciences, Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli , , Bologna, BO, Italy. lorenzo.pelizza@unibo.it. Department of Mental Health and Pathological Addictions, Azienda USL di Parma, Largo Palli /a, , Parma, Italy. Department of Mental Health and Pathological Addictions, Azienda USL-IRCCS di Reggio Emilia, Via Amendola , , Reggio Emilia, Italy. Division of Pain Medicine, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci , , Parma, Italy. Department of Mental Health and Pathological Addictions, Azienda USL di Bologna, Via Castiglione , , Bologna, Italy. Department of Biomedical and Neuromotor Sciences, Psychiatry Institute, "Alma Mater Studiorum" Università degli Studi di Bologna, Via Pepoli , , Bologna, BO, Italy.

Abstract summary 

Borderline Personality Disorder (BPD) is under-recognized in First-Episode Psychosis (FEP) and its psychotic manifestations are difficult to differentiate from Schizophrenia Spectrum Disorders (SSD). The aim of this investigation was to compare clinical, sociodemographic, and outcome characteristics between FEP patients with BPD vs. FEP subjects with SSD both at baseline and across a 2-year follow-up period. Participants completed the Health of the Nation Outcome Scale (HoNOS), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF) scale both at entry and every 12 months during the follow-up. A mixed-design ANOVA model was conducted to investigate the temporal stability of clinical scores within and between the two subgroups. Among 356 FEP participants, 49 had a BPD diagnosis. Compared to FEP/SSD (n = 307), FEP/BPD patients showed higher prevalence of employment, current substance use, and past attempted suicide. They had a lower equivalent dose of antipsychotic medication at entry and lower levels of negative symptoms. Finally, they had a higher 2-year drop-out rate and a significant improvement in psychopathological scores limited to the first year of treatment. BPD as categorical entity represents a FEP subgroup with specific clinical challenges. Appropriate treatment guidelines for this FEP subgroup are thus needed.

Authors & Co-authors:  Pelizza Leuci Quattrone Azzali Paulillo Pupo Pellegrini Gammino Biancalani Menchetti

Study Outcome 

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Citations :  Sarteschi P, Maggini C (1982) Manuale di psichiatria. Monduzzi, Pisa
Authors :  10
Identifiers
Doi : 10.1007/s00406-024-01772-5
SSN : 1433-8491
Study Population
Male,Female
Mesh Terms
Other Terms
Borderline personality disorder;Early intervention;Early psychosis;Schizophrenia spectrum disorder
Study Design
Study Approach
Country of Study
Publication Country
Germany