Current Psychiatry Reports

, 21:125 | Cite as

Differential Diagnosis of Bipolar II Disorder and Borderline Personality Disorder

  • Adam BayesEmail author
  • Gordon Parker
  • Joel Paris
Bipolar Disorders (R Hirschfeld, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Bipolar Disorders


Purpose of Review

Differentiating bipolar (BP) disorders (in particular BP II) from borderline personality disorder (BPD) is a common diagnostic dilemma. We sought to critically examine recent studies that considered clinical differences between BP II and BPD, which might advance their delineation.

Recent Findings

Recent studies focused on differentiating biological parameters—genetics, epigenetics, diurnal rhythms, structural and functional neuroimaging—with indicative differences not yet sufficient to guide diagnosis. Key differentiating factors include family history, developmental antecedents, illness course, phenomenological differences in mood states, personality style and relationship factors. Less differentiating factors include impulsivity, neuropsychological profiles, gender distribution, comorbidity and treatment response.


This review details parameters offering differentiation of BP II from BPD and should assist in resolving a frequent diagnostic dilemma. Future studies should specifically examine the BP II subtype directly with BPD, which would aid in sharpening the distinction between the disorders.


Bipolar disorder Borderline personality disorder Diagnosis Affective instability 


Compliance with Ethical Standards

Conflict of Interest

Adam Bayes, Gordon Parker and Joel Paris each declare no potential conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of PsychiatryUniversity of New South Wales (UNSW)SydneyAustralia
  2. 2.Black Dog InstituteSydneyAustralia
  3. 3.Institute of Community and Family Psychiatry, SMBD-Jewish General HospitalMcGill UniversityMontrealCanada

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