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Antisocial Personality Disorder in Bipolar Disorder: A Systematic Review

Background and Objectives: Bipolar Disorder (BD) is a severe psychiatric disorder that worsens quality of life and functional impairment. Personality disorders (PDs), in particular Cluster B personality, have a high incidence among BD patients and is considered a poor prognostic factor. The study of...

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Autores principales: Carbone, Elvira Anna, de Filippis, Renato, Caroleo, Mariarita, Calabrò, Giuseppina, Staltari, Filippo Antonio, Destefano, Laura, Gaetano, Raffaele, Steardo, Luca, De Fazio, Pasquale
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924170/
https://www.ncbi.nlm.nih.gov/pubmed/33672619
http://dx.doi.org/10.3390/medicina57020183
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author Carbone, Elvira Anna
de Filippis, Renato
Caroleo, Mariarita
Calabrò, Giuseppina
Staltari, Filippo Antonio
Destefano, Laura
Gaetano, Raffaele
Steardo, Luca
De Fazio, Pasquale
author_facet Carbone, Elvira Anna
de Filippis, Renato
Caroleo, Mariarita
Calabrò, Giuseppina
Staltari, Filippo Antonio
Destefano, Laura
Gaetano, Raffaele
Steardo, Luca
De Fazio, Pasquale
author_sort Carbone, Elvira Anna
collection PubMed
description Background and Objectives: Bipolar Disorder (BD) is a severe psychiatric disorder that worsens quality of life and functional impairment. Personality disorders (PDs), in particular Cluster B personality, have a high incidence among BD patients and is considered a poor prognostic factor. The study of this co-morbidity represents an important clinical and diagnostic challenge in psychiatry. Particularly, clinical overlap has been shown between antisocial personality disorder (ASPD) and BD that could worsen the course of both disorders. We aimed to detect the frequency of ASPD in bipolar patients with greater accuracy and the impact of ASPD on the clinical course of BD. Materials and Methods: A systematic literature search was conducted in PubMed, Embase, MEDLINE and the Cochrane Library through December 2020 without language or time restriction, according to PRISMA statement guidelines. Results: Initially, 3203 items were identified. After duplicates or irrelevant paper deletion, 17 studies met the inclusion criteria and were included in this review. ASPD was more frequent among BD patients, especially in BD type I. BD patients with ASPD as a comorbidity seemed to have early onset, higher number and more severe affective episodes, higher levels of aggressive and impulsive behaviors, suicidality and poor clinical outcome. ASPD symptoms in BD seem to be associated with a frequent comorbidity with addictive disorders (cocaine and alcohol) and criminal behaviors, probably due to a shared impulsivity core feature. Conclusions: Considering the shared symptoms such as impulsive and dangerous behaviors, in patients with only one disease, misdiagnosis is a common phenomenon due to the overlapping symptoms of ASPD and BD. It may be useful to recognize the co-occurrence of the disorders and better characterize the patient with ASPD and BD evaluating all dysfunctional aspects and their influence on core symptoms.
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spelling pubmed-79241702021-03-03 Antisocial Personality Disorder in Bipolar Disorder: A Systematic Review Carbone, Elvira Anna de Filippis, Renato Caroleo, Mariarita Calabrò, Giuseppina Staltari, Filippo Antonio Destefano, Laura Gaetano, Raffaele Steardo, Luca De Fazio, Pasquale Medicina (Kaunas) Review Background and Objectives: Bipolar Disorder (BD) is a severe psychiatric disorder that worsens quality of life and functional impairment. Personality disorders (PDs), in particular Cluster B personality, have a high incidence among BD patients and is considered a poor prognostic factor. The study of this co-morbidity represents an important clinical and diagnostic challenge in psychiatry. Particularly, clinical overlap has been shown between antisocial personality disorder (ASPD) and BD that could worsen the course of both disorders. We aimed to detect the frequency of ASPD in bipolar patients with greater accuracy and the impact of ASPD on the clinical course of BD. Materials and Methods: A systematic literature search was conducted in PubMed, Embase, MEDLINE and the Cochrane Library through December 2020 without language or time restriction, according to PRISMA statement guidelines. Results: Initially, 3203 items were identified. After duplicates or irrelevant paper deletion, 17 studies met the inclusion criteria and were included in this review. ASPD was more frequent among BD patients, especially in BD type I. BD patients with ASPD as a comorbidity seemed to have early onset, higher number and more severe affective episodes, higher levels of aggressive and impulsive behaviors, suicidality and poor clinical outcome. ASPD symptoms in BD seem to be associated with a frequent comorbidity with addictive disorders (cocaine and alcohol) and criminal behaviors, probably due to a shared impulsivity core feature. Conclusions: Considering the shared symptoms such as impulsive and dangerous behaviors, in patients with only one disease, misdiagnosis is a common phenomenon due to the overlapping symptoms of ASPD and BD. It may be useful to recognize the co-occurrence of the disorders and better characterize the patient with ASPD and BD evaluating all dysfunctional aspects and their influence on core symptoms. MDPI 2021-02-20 /pmc/articles/PMC7924170/ /pubmed/33672619 http://dx.doi.org/10.3390/medicina57020183 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Carbone, Elvira Anna
de Filippis, Renato
Caroleo, Mariarita
Calabrò, Giuseppina
Staltari, Filippo Antonio
Destefano, Laura
Gaetano, Raffaele
Steardo, Luca
De Fazio, Pasquale
Antisocial Personality Disorder in Bipolar Disorder: A Systematic Review
title Antisocial Personality Disorder in Bipolar Disorder: A Systematic Review
title_full Antisocial Personality Disorder in Bipolar Disorder: A Systematic Review
title_fullStr Antisocial Personality Disorder in Bipolar Disorder: A Systematic Review
title_full_unstemmed Antisocial Personality Disorder in Bipolar Disorder: A Systematic Review
title_short Antisocial Personality Disorder in Bipolar Disorder: A Systematic Review
title_sort antisocial personality disorder in bipolar disorder: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924170/
https://www.ncbi.nlm.nih.gov/pubmed/33672619
http://dx.doi.org/10.3390/medicina57020183
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