Differentiation of bipolar disorder versus borderline personality disorder: A machine learning approach.

Bipolar disorder Borderline personality disorder Diagnosis Emotion regulation Machine learning

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 06 2021
Historique:
received: 21 01 2021
revised: 19 03 2021
accepted: 23 03 2021
pubmed: 13 4 2021
medline: 6 7 2021
entrez: 12 4 2021
Statut: ppublish

Résumé

Differentiation of bipolar disorder (BP) from borderline personality disorder (BPD) is a common diagnostic dilemma. We undertook a machine learning (ML) approach to distinguish the conditions. Participants meeting DSM criteria for BP or BPD were compared on measures examining cognitive and behavioral BPD constructs, emotion regulation strategies, and parental behaviors during childhood. Two analyses used continuous and dichotomised data, with ML-allocated diagnoses compared to DSM. 82 participants met DSM criteria for BP and 52 for BPD. Accuracy of ML classification was 84.1% - 87.8% for BP, 50% - 57.7% for BPD, with overall accuracy of 73.1% - 73.9%. Importance of items differed between the analyses with the overall most important items including identity difficulties, relationship problems, female gender, feeling suicidal after a relationship breakdown and age. Participants were volunteers, preponderance of bipolar II (BP II) participants, comorbidity of BP and BPD not examined, and small BPD sample contributed to the relatively low classification accuracies for this group CONCLUSIONS: Study findings may assist distinguishing BP and BPD based on differences in cognitive and behavioral domains, emotion regulation strategies and parental behaviors. Future studies using larger datasets could further improve predictive accuracy and assist in differential diagnosis.

Sections du résumé

BACKGROUND
Differentiation of bipolar disorder (BP) from borderline personality disorder (BPD) is a common diagnostic dilemma. We undertook a machine learning (ML) approach to distinguish the conditions.
METHODS
Participants meeting DSM criteria for BP or BPD were compared on measures examining cognitive and behavioral BPD constructs, emotion regulation strategies, and parental behaviors during childhood. Two analyses used continuous and dichotomised data, with ML-allocated diagnoses compared to DSM.
RESULTS
82 participants met DSM criteria for BP and 52 for BPD. Accuracy of ML classification was 84.1% - 87.8% for BP, 50% - 57.7% for BPD, with overall accuracy of 73.1% - 73.9%. Importance of items differed between the analyses with the overall most important items including identity difficulties, relationship problems, female gender, feeling suicidal after a relationship breakdown and age.
LIMITATIONS
Participants were volunteers, preponderance of bipolar II (BP II) participants, comorbidity of BP and BPD not examined, and small BPD sample contributed to the relatively low classification accuracies for this group CONCLUSIONS: Study findings may assist distinguishing BP and BPD based on differences in cognitive and behavioral domains, emotion regulation strategies and parental behaviors. Future studies using larger datasets could further improve predictive accuracy and assist in differential diagnosis.

Identifiants

pubmed: 33845326
pii: S0165-0327(21)00317-7
doi: 10.1016/j.jad.2021.03.082
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

68-73

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

Auteurs

Adam Bayes (A)

Black Dog Institute, Hospital Rd, Randwick, NSW 2031, Australia. Electronic address: a.bayes@unsw.edu.au.

Michael J Spoelma (MJ)

School of Psychiatry, University of New South Wales, NSW, Australia.

Dusan Hadzi-Pavlovic (D)

School of Psychiatry, University of New South Wales, NSW, Australia.

Gordon Parker (G)

School of Psychiatry, University of New South Wales, NSW, Australia.

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