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Borderline Personality Disorder, Atypical Depression, and Cyclothymia: Diagnostic Distinctions Crossing Mood and Personality Disorders Borders

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Borderline Personality and Mood Disorders

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Abstract

Atypical depression, cyclothymia, and borderline personality disorder are three diagnostic terms used to describe the clinical presentations of patients with both chronic affective instability and interpersonal sensitivity. The historical development of these diagnostic concepts represents separate streams of effort in defining features of patients prone to develop complex configurations of psychiatric comorbidities and poor treatment response. While a small empirical literature has studied the relationship between these disorders, the boundaries between them remain unclear. The evidence-based treatment for atypical depression and cylcothymia promotes the use of medications like MAOIs (monoamine oxidase inhibitors) and lithium, with significant side effect burdens and lethality in overdose. Psychotherapeutic approaches are established as the primary treatment modality for BPD, but are inadequately tested for atypical depression and cyclothymia. In clinical presentations where all three diagnoses are possible, a combined approach utilizing psychotherapy to stabilize interpersonal sensitivities and affective instability with adjunctive mood stabilizing agents may optimize the long-term outcomes for this chronic and functionally challenged group of patients.

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References

  1. Bassett D. Borderline personality disorder and bipolar affective disorder. Spectra of spectre? A review. Aust N Z J Psychiatry. 2012;46:327–39.

    PubMed  Google Scholar 

  2. Vorma H, Naukkarinen HH, Sama SJ, Kuoppasalmi KI. Predictors of benzodiazepine discontinuation in subjects manifesting complicated dependence. Subst Use Misuse. 2005;40(4):499–510.

    PubMed  Google Scholar 

  3. Frankenburg FR, Zanarini MC. Personality disorders and medical comorbidity. Curr Opin Psychiatry. 2006;19(4):428–31.

    PubMed  Google Scholar 

  4. Frankenburg FR, Zanarini MC. Obesity and obesity-related illnesses in borderline patients. J Pers Disord. 2006;20(1):71–80.

    PubMed  Google Scholar 

  5. Baldessarini RJ, Vieta E, Calabrese JR, Tohen M, Bowden CL. Bipolar depression: overview and commentary. Harv Rev Psychiatry. 2010;18(3):143–57.

    PubMed  Google Scholar 

  6. Rabkin JG, Stewart JW, Quitkin FM, McGrath PJ, Harrison WM, Klein DF. Should atypical depression be included in DSM-IV. In: Widiger TA, Frances AJ, Pincus HA, Ross R, First MB, Davis WW, editors. DSM-IV sourcebook. Washington, DC: American Psychiatric Association; 1996.

    Google Scholar 

  7. Baldessarini RJ, Vazquez G, Tondo L. Treatment of cyclothymic disorder: commentary. Psychother Psychosom. 2011;80(3):131–5.

    PubMed  Google Scholar 

  8. Gabbard GO. Do all roads lead to Rome? New finding on borderline personality disorder. Am J Psychiatry. 2007;164(6):853–5.

    PubMed  Google Scholar 

  9. Bateman AW. Treating borderline personality disorder in clinical practice. Am J Psychiatry. 2012;169(6):560–3.

    PubMed  Google Scholar 

  10. Akiskal H, Chen SE, Davis GC, Puzantian VR, Kashgarian MM, Bolinger JM. Borderline: an adjective in search of a noun. J Clin Psychiatry. 1985;46(2):41–8.

    PubMed  CAS  Google Scholar 

  11. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.

    Google Scholar 

  12. Akiskal HS. Delineating irritable and hyperthymic variants of the cyclothymic temperament. J Pers Disord. 1992;6(4):4.

    Google Scholar 

  13. Perugi G, Fornaro M, Akiskal AS. Are atypical depression, borderline personality disorder and bipolar II disorder overlapping manifestations of a core cyclothymic diathesis? World Psychiatry. 2011;10(1):45–51.

    PubMed  PubMed Central  Google Scholar 

  14. West ED, Dally PJ. Effects of iproniazid in depressive syndromes. Br Med J. 1959;1(5136):1491–4.

    PubMed  CAS  PubMed Central  Google Scholar 

  15. Sargant W. Some newer drugs in the treatment of depression and their relation to other somatic treatments. Psychosomatics. 1960;1(1):14–7.

    Google Scholar 

  16. Sargant WW, Slater E. An introduction to physical methods of treatment in psychiatry. New York: Science House; 1972.

    Google Scholar 

  17. Parker G, Roy K, Mitchell P, Wilhelm K, Malhi G, Hadzi-Pavlovic D. Atypical depression: a reappraisal. Am J Psychiatry. 2002;159(9):1470–9.

    PubMed  Google Scholar 

  18. Klein DF, Davis JM. Diagnosis and drug treatment of psychiatric disorders. Baltimore: Williams & Wilkins; 1969.

    Google Scholar 

  19. Liebowitz MR, Klein DF. Hysteroid dysphoria. Psychiatr Clin North Am. 1979;2:555–75.

    Google Scholar 

  20. Beeber A, Kline M, Pies R, Manring J. Hysteroid dysphoria in depressed inpatients. J Clin Psychiatry. 1984;45(4):164–6.

    PubMed  CAS  Google Scholar 

  21. Liebowitz MR, Klein DF. Interrelationship of hysteroid dysphoria and borderline personality disorder. Psychiatr Clin North Am. 1981;4(1):67–87.

    PubMed  CAS  Google Scholar 

  22. Spitzer RL, Williams JB. Hysteroid dysphoria: an unsuccessful attempt to demonstrate its syndromal validity. Am J Psychiatry. 1982;139(10):1286–91.

    PubMed  CAS  Google Scholar 

  23. Stewart JW, McGrath PJ, Rabkin JG, Quitkin FM. Atypical depression. A valid clinical entity? Psychiatr Clin North Am. 1993;16(3):479–95.

    PubMed  CAS  Google Scholar 

  24. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  25. Posternack MA, Zimmerman M. Partial validation of the atypical features subtype of major depressive disorder. Arch Gen Psychiatry. 2002;59:70–6.

    Google Scholar 

  26. Seemüller F, Riedel M, Wickelmaier F, Adli M, Mundt C, Marneros A, et al. Atypical symptoms in hospitalised patients with major depressive episode: frequency, clinical characteristics, and internal validity. J Affect Disord. 2008;108(3):271–8.

    PubMed  Google Scholar 

  27. Davidson J, Miller R, Turnbull C, Sullivan JL. Atypical depression. Arch Gen Psychiatry. 1982;39(5):527–34.

    PubMed  CAS  Google Scholar 

  28. Parker G, McCraw S, Fletcher K. Cyclothymia. Depress Anxiety. 2012;29(6):487–94.

    PubMed  Google Scholar 

  29. Joyce PR, Mulder R, McKenzie JM, Luty SE, Cloninger CR. Atypical depression, atypical temperament and a differential antidepressant response to fluoxetine and nortriptyline. Depress Anxiety. 2004;19(3):180–6.

    PubMed  CAS  Google Scholar 

  30. Thase ME, Frank E, Kornstein SG, Yonkers KA. Gender differences in response to treatment for depression. In: Frank E, editor. Gender and its effects on psychopathology. Washington, DC: American Psychiatric Press; 2000.

    Google Scholar 

  31. Parker GB, Thase ME. Atypical depression: a valid subtype? J Clin Psychiatry. 2007;68(S3):e08.

    PubMed  Google Scholar 

  32. Perugi G, Toni C, Travierso MC, Akiskal HS. The role of cyclothymia in atypical depression: toward a data-based reconceptualization of the borderline-bipolar II connection. J Affect Disord. 2003;73(1–2):87–98.

    PubMed  Google Scholar 

  33. Kraeplin E, editor. Manic-depressive insanity and paranoia. Edinburgh: ES Livingstone; 1921.

    Google Scholar 

  34. Brieger P, Marneros A. Dysthymia and cyclothymia: historical origins and contemporary development. J Affect Disord. 1997;45(3):117–26.

    PubMed  CAS  Google Scholar 

  35. Akiskal HS. Dysthymia and cyclothymia in psychiatric practice a century after Kraepelin. J Affect Disord. 2001;62(1–2):17–31.

    PubMed  CAS  Google Scholar 

  36. Koukopoulus A. Ewald Hecker’s description of cyclothymia as a cyclical mood disorder: its relevance to the modern concept of bipolar II. J Affect Disord. 2003;73(1–2):199–205.

    Google Scholar 

  37. Kahlbaum KL. Ueber cyklisches Irresein. Der Irrenfreund. 1882;24:145–57.

    Google Scholar 

  38. Schneider K. Psychopathic personalities. Springfield: Charles C. Thomas; 1958.

    Google Scholar 

  39. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 2nd ed. Washington, DC: American Psychiatric Association; 1968.

    Google Scholar 

  40. Angst J. On the etiology and nosology of endogenous depressive psychoses. A genetic, sociologic and clinical study. Monogr Gesamtgeb Neurol Psychiatr. 1966;112(1):1–118.

    PubMed  CAS  Google Scholar 

  41. Perris C, d’Elia G. A Study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. X. Morality, suicide and life-cycles. Acta Psychiatr Scand. 1966;194:172–89.

    CAS  Google Scholar 

  42. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington, DC: American Psychiatric Association; 1984.

    Google Scholar 

  43. Akiskal HS. The prevalent clinical spectrum of bipolar disorders: beyond DSM-IV. J Clin Psychopharmacol. 1996;16(2S):4S–14.

    PubMed  CAS  Google Scholar 

  44. Stern A. Psychoanalytic investigation of and therapy in the border line group of neuroses. Psychoanal Q. 1938;7(4):467–89.

    Google Scholar 

  45. Zilboorg G. Ambulatory schizophrenia. Psychiatry. 1941;4:149–55.

    Google Scholar 

  46. Peterson DR. The diagnosis of subclinical schizophrenia. J Consult Psychol. 1954;18(3):198–200.

    PubMed  CAS  Google Scholar 

  47. Hoch P, Cattell J. The diagnosis of pseudoneurotic schizophrenia. Psychiatr Q. 1959;33:17–43.

    PubMed  CAS  Google Scholar 

  48. Hoch P, Polatin P. Pseudoneurotic forms of schizophrenia. Psychiatr Q. 1949;23(2):248–76.

    PubMed  CAS  Google Scholar 

  49. Schmideberg M. The treatment of psychopaths and borderline patients. Am J Psychother. 1947;1(1):45–70.

    PubMed  CAS  Google Scholar 

  50. Knight R. Borderline states. Bull Menninger Clin. 1953;17(1):1–12.

    PubMed  CAS  Google Scholar 

  51. Kernberg O. Borderline personality organization. J Am Psychoanal Assoc. 1967;15(3):641–85.

    PubMed  CAS  Google Scholar 

  52. Grinker RR, Werble B, Drye R. The borderline syndrome. New York: Basic Books; 1968.

    Google Scholar 

  53. Gunderson JG, Singer MT. Defining borderline patients: an overview. Am J Psychiatry. 1975;132(1):1–10.

    PubMed  CAS  Google Scholar 

  54. Gunderson JG, Kolb JE. Discriminating features of borderline patients. Am J Psychiatry. 1978;135(7):792–6.

    PubMed  CAS  Google Scholar 

  55. Gunderson JG, Links PS. Borderline personality disorder: a clinical guide. Washington, DC: American Psychiatric Publishing; 2008.

    Google Scholar 

  56. Robins E, Guze SB. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry. 1970;126(7):983–7.

    PubMed  CAS  Google Scholar 

  57. Gunderson JG. Borderline personality disorder: ontogeny of a diagnosis. Am J Psychiatry. 2009;166(5):530–9.

    PubMed  PubMed Central  Google Scholar 

  58. Skodol AE, Siever LJ, Livesley WJ, Gunderson JG, Pfohl B, Widiger TA. The borderline diagnosis II: biology, genetics, and clinical course. Biol Psychiatry. 2002;51(12):951–63.

    PubMed  Google Scholar 

  59. Skodol AE, Gunderson JG, Pfohl B, Widiger TA, Livesely WJ, Siever LJ. The borderline diagnosis I: psychopathology, comorbidity, and personality structure. Biol Psychiatry. 2002;51(12):936–50.

    PubMed  Google Scholar 

  60. Zanarini MC, Frankenburg FR, Reich DB, Silk KR, Hudson JI, McSweeney LB. The subsyndromal phenomenology of borderline personality disorder: a 10-year follow-up study. Am J Psychiatry. 2007;164(6):929–35.

    PubMed  Google Scholar 

  61. Gunderson JG, Stout RL, McGlashan TH, Shea MT, Morey LC, Grilo CM, et al. Ten-year course of borderline personality disorder: psychopathology and function from the Collaborative Longitudinal Personality Disorders study. Arch Gen Psychiatry. 2011;68(8):827–37.

    PubMed  PubMed Central  Google Scholar 

  62. Gunderson JG, Zanarini MC, Choi-Kain LW, Mitchell KS, Jang KL, Hudson JI. Family study of borderline personality disorder and its sectors of psychopathology. Arch Gen Psychiatry. 2011;68(7):753–62.

    PubMed  PubMed Central  Google Scholar 

  63. Distel MA, Willemsen G, Ligthar L, Derom CA, Martin NG, Meale MC, et al. Genetic covariance structure of the four main features of borderline personality disorder. J Pers Disord. 2010;24(4):427–44.

    PubMed  PubMed Central  Google Scholar 

  64. Widiger TA, Lowe JR. A dimensional model of personality disorder: proposal for DSM-V. Psychiatr Clin North Am. 2008;31(3):363–78.

    PubMed  Google Scholar 

  65. Skodol AE, Bender DS. The future of personality disorders in DSM-V? Am J Psychiatry. 2009;166(4):388–91.

    PubMed  Google Scholar 

  66. Costa PTJ, McCrae RR. Revised NEO personality inventory: professional manual (NEO-PI-R). Odessa: Psychological Assessment Resources; 1992.

    Google Scholar 

  67. Shedler J, Westen D. Dimensions of personality pathology: an alternative to the five-factor model. Am J Psychiatry. 2004;161(10):1743–54.

    PubMed  Google Scholar 

  68. American Psychiatric Association. Personality and personality disorders. Washington, DC: American Psychiatric Association; 2010.

    Google Scholar 

  69. Rottman BM, Ahn W, Sanislow CA, Kim NS. Can clinicians recognize DSM-IV personality disorders from five-factor model descriptions of patient cases? Am J Psychiatry. 2009;166(4):427–33.

    PubMed  PubMed Central  Google Scholar 

  70. Zanarini MC, Frankenburg FR, Dubo E, Sickel A, Trikha A, Levin A, et al. Axis I comorbidity of borderline personality disorder. Am J Psychiatry. 1998;155(12):1733–9.

    PubMed  CAS  Google Scholar 

  71. Eaton NR, Krueger RF, Keyes KM, Skodol AE, Markon KE, Grant BF, et al. Borderline personality disorder co-morbidity: relationship to the internalizing-externalizing structure of common mental disorders. Psychol Med. 2011;41(5):1041–50.

    PubMed  CAS  PubMed Central  Google Scholar 

  72. Cristancho MA, O’Reardon JP, Thase ME. Atypical depression in the 21st century: diagnostic and treatment issues. Psychiatr Times. 2011;28(1):42–47.

    Google Scholar 

  73. Yen S, Pagano ME, Shea M, Grilo CM, Gunderson JG, Skodol AE, et al. Recent life events preceding suicide attempts in a personality disorder sample: findings from the collaborative longitudinal personality disorders study. J Consult Clin Psychol. 2005;73(1):99–105.

    PubMed  PubMed Central  Google Scholar 

  74. Brodsky BS, Groves SA, Oquendo MA, Mann JJ, Stanley B. Interpersonal precipitants and suicide attempts in borderline personality disorder. Suicide Life Threat Behav. 2006;36(3):313–22.

    PubMed  Google Scholar 

  75. Westen D, Moses J, Silk KR, Lohr NE, Cohen R, Segal H. Quality of depressive experience in borderline personality disorders: when depression is not just depression. J Pers Disord. 1992;6(4):382–93.

    Google Scholar 

  76. Silk KR. The quality of depression in borderline personality disorder and the diagnostic process. J Pers Disord. 2010;24(1):25–37.

    PubMed  Google Scholar 

  77. Fossati A, Maffei C, Bagnato M, Donati D, Namia C, Novella L. Latent structure analysis of DSM-IV borderline personality disorder criteria. Compr Psychiatry. 1999;40(1):72–9.

    PubMed  CAS  Google Scholar 

  78. Sanislow CA, Grilo CM, McGlashan TH. Factor analysis of the DSM-III-R borderline personality disorder criteria in psychiatric inpatients. Am J Psychiatry. 2000;157(10):1629–33.

    PubMed  CAS  Google Scholar 

  79. Clifton A, Pilkonis PA. Evidence for a single latent class of Diagnostic and Statistical Manual of Mental Disorders borderline personality pathology. Compr Psychiatry. 2007;48(1):70–8.

    PubMed  Google Scholar 

  80. Linehan M. Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press; 1993.

    Google Scholar 

  81. Gunderson JG, Lyons-Ruth K. BPD’s interpersonal hypersensitivity phenotype: a gene-environment-developmental model. J Pers Disord. 2008;22(1):22–41.

    PubMed  PubMed Central  Google Scholar 

  82. Gunderson JG. Disturbed relationships as a phenotype for borderline personality disorder. Am J Psychiatry. 2007;164(11):1637–40.

    PubMed  Google Scholar 

  83. Downey G, Feldman SI. Implications of rejection sensitivity for intimate relationships. J Pers Soc Psychol. 1996;70(6):1327–43.

    PubMed  CAS  Google Scholar 

  84. Staebler K, Helbing E, Rosenbach C, Renneberg B. Rejection sensitivity and borderline personality disorder. Clin Psychol Psychother. 2011;18(4):275–83.

    PubMed  Google Scholar 

  85. Berenson KR, Downey G, Rafaeli E, Coifman KG, Paguin NL. The rejection-rage contingency in borderline personality disorder. J Abnorm Psychol. 2011;120(3):681–90.

    PubMed  Google Scholar 

  86. Miano A, Fertuck EA, Arntz A, Stanley B. Rejection sensitivity is a mediator between borderline personality disorder features and facial trait appraisal. J Pers Disord. 2013;27(4):442–56.

    PubMed  Google Scholar 

  87. Gunderson JG. Revising the borderline diagnosis for DSM-V: an alternative proposal. J Pers Disord. 2010;24(6):694–708.

    PubMed  PubMed Central  Google Scholar 

  88. Rimes KA, Chalder T. The Beliefs about Emotions Scale: validity, reliability and sensitivity to change. J Psychosom Res. 2010;68(3):285–92.

    PubMed  Google Scholar 

  89. Soloff PH, George A, Nathan RS, Schulz PM. Characterizing depression in borderline patients. J Clin Psychiatry. 1987;48(4):155–7.

    PubMed  CAS  Google Scholar 

  90. Ohmae S. The modern concept of atypical depression: four definitions. Seishin Shinkeigaku Zasshi. 2010;112(1):3–22.

    PubMed  Google Scholar 

  91. Akiskal HS. Delineating irritable and hyperthymic variants of the cyclothymic temperament. J Pers Disord. 1992;6(4):326–42.

    Google Scholar 

  92. Rihmer Z, Akiskal KK, Rihmer A, Akiskal HS. Current research on affective temperaments. Curr Opin Psychiatry. 2010;23(1):12–8.

    PubMed  Google Scholar 

  93. Reich B, Zanarini M, Fitzmaurice G. Affective lability in bipolar disorder and borderline personality disorder. Compr Psychiatry. 2012;53:230–7.

    PubMed  Google Scholar 

  94. Akiskal HS. Demystifying borderline personality: critique of the concept and unorthodox reflections on its natural kinship with the bipolar spectrum. Acta Psychiatr Scand. 2004;110(6):403.

    Google Scholar 

  95. Levitt AJ, Joffe RT, Ennis J, MacDonald C, Kutcher SP. The prevalence of cyclothymia in borderline personality disorder. J Clin Psychiatry. 1990;51(8):335–9.

    PubMed  CAS  Google Scholar 

  96. MacDonald K, Berlow R, Thomas ML. Attachment, affective temperament, and personality disorders: a study of their relationships in psychiatric outcomes. J Affect Disord. 2013;151(3):932–41.

    PubMed  Google Scholar 

  97. Stewart JW. Treating depression with atypical features. J Clin Psychiatry. 2007;68(S3):25–9.

    PubMed  Google Scholar 

  98. Beck AT, Rush AJ, Shaw BF, et al. Cognitive therapy of depression. Guilford clinical psychology and psychotherapy series. Guilford: New York; 1979.

    Google Scholar 

  99. Ingenhoven T, Lafay P, Rinne T, Passchier J, Duivenvoorden H. Effectiveness of pharmacotherapy for severe personality disorders: meta-analyses of randomized controlled trials. J Clin Psychiatry. 2010;71(1):14–25.

    PubMed  CAS  Google Scholar 

  100. Ripoll LH, Triebwasser J, Siever LJ. Evidence-based pharmacotherapy for personality disorders. Int J Neuropsychopharmacol. 2011;14(9):1257–88.

    PubMed  Google Scholar 

  101. Gunderson JG, Morey LC, Stout RL, Skodol AE, Shea MT, McGlashan TH, et al. Major depressive disorder and borderline personality disorder revisited: longitudinal interactions. J Clin Psychiatry. 2004;65(8):1049–56.

    PubMed  Google Scholar 

  102. Parsons B, Quitkin FM, McGrath PJ, Stewart JW, Tricamo E, Ocepek-Welikson K, et al. Phenelzine, imipramine, and placebo in borderline patients meeting criteria for atypical depression. Psychopharmacol Bull. 1989;25(4):524–34.

    PubMed  CAS  Google Scholar 

  103. Soloff PH, Cornelius J, George A, Nathan S, Perel JM, Ulrich RF. Efficacy of phenelzine and haloperidol in borderline personality disorder. Arch Gen Psychiatry. 1993;50(5):377–85.

    PubMed  CAS  Google Scholar 

  104. Eisenberger NI, Way BM, Taylor SE, Welch VT, Lieberman MD. Understanding genetic risk for aggression: clues from the brain’s response to social exclusion. Biol Psychiatry. 2007;61(9):1100–8.

    PubMed  Google Scholar 

  105. Neubauer H, Bermingham P. A depressive syndrome responsive to lithium: an analysis of 20 cases. J Nerv Ment Dis. 1976;163(4):276–81.

    PubMed  CAS  Google Scholar 

  106. Akiskal HS, Khani MK, Scott-Strauss A. Cyclothymic temperamental disorders. Psychiatr Clin North Am. 1979;2(3):527–54.

    Google Scholar 

  107. Peselow E, Dunner D, Fieve R, Lautin A. Lithium prophylaxis of depression in unipolar, bipolar II, and cyclothymic patients. Am J Psychiatry. 1982;139(6):747–52.

    PubMed  CAS  Google Scholar 

  108. Links PS, Steiner M, Boiago I, Irwin D. Lithium therapy for borderline patients: preliminary findings. J Pers Disord. 1990;4(2):173–81.

    Google Scholar 

  109. Van Meter AR, Youngstrom EA, Findling RL. Cyclothymic disorder: a critical review. Clin Psychol Rev. 2012;32(4):229–43.

    PubMed  Google Scholar 

  110. Fava GA, Rafenelli C, Tomba E, Guidi J, Grandi S. The sequential combination of cognitive behavioral treatment and well-being therapy in cyclothymic disorder. Psychother Psychosom. 2011;80(3):136–43.

    PubMed  Google Scholar 

  111. Lieb K, Völlm B, Rücker G, Timmer A, Stoffers JM. Pharmacotherapy for borderline personality disorder: Cochrane systematic review of randomised trials. Br J Psychiatry. 2010;196(1):4–12.

    PubMed  Google Scholar 

  112. Davidson K, Norrie J, Tyrer P, Gumley A, Tata P, Murray H, et al. The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial. J Pers Disord. 2006;20(5):450–65.

    PubMed  PubMed Central  Google Scholar 

  113. Davidson KM, Tyrer P, Norrie J, Palmer SJ, Tyrer H. Cognitive therapy v. usual treatment for borderline personality disorder: prospective 6-year follow-up. The. Br J Psychiatry. 2010;197(6):456–62.

    PubMed  Google Scholar 

  114. Bateman A, Fonagy P. Psychotherapy for borderline personality disorder: mentalization based treatment (Bateman, psychotherapy for borderline personality disorder). Oxford/New York: Oxford University Press; 2004.

    Google Scholar 

  115. Clarkin JF, Yeomans F, Kernberg OF. Psychotherapy for borderline personality: focusing on object relations. New York: Wiley; 2006.

    Google Scholar 

  116. Bateman A, Fonagy P. 8-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment as usual. Am J Psychiatry. 2008;165(5):631–8.

    PubMed  Google Scholar 

  117. Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, et al. Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by exports for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry. 2006;63(7):757–66.

    PubMed  Google Scholar 

  118. McMain SF, Links PS, Gnam WH, Guimond T, Cardish RJ, Korman L, Streiner DL. A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. Am J Psychiatry. 2009;166(12):1365–74.

    PubMed  Google Scholar 

  119. McMain SF, Guimond T, Streiner DL, Cardish RJ, Links PS. Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up. Am J Psychiatry. 2012;169(6):650–61.

    PubMed  Google Scholar 

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Acknowledgments

We would like to acknowledge Evan Lamont in his assistance with the literature review for this chapter.

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  1. Department of Psychiatry, Harvard Medical School, 115 Mill Street, Belmont, MA, 02478, USA

    Lois W. Choi-Kain MD, MEd & Ana M. Rodriguez-Villa BA

  2. Department of Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA

    Lois W. Choi-Kain MD, MEd & Ana M. Rodriguez-Villa BA

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Correspondence to Lois W. Choi-Kain MD, MEd .

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  1. McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA

    Lois W. Choi-Kain

  2. McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA

    John G. Gunderson

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Choi-Kain, L.W., Rodriguez-Villa, A.M. (2015). Borderline Personality Disorder, Atypical Depression, and Cyclothymia: Diagnostic Distinctions Crossing Mood and Personality Disorders Borders. In: Choi-Kain, L., Gunderson, J. (eds) Borderline Personality and Mood Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1314-5_3

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