The association between borderline personality disorder, FM and CFS: systematic review

[Effi]

http://bjpo.rcpsych.org/content/2/4/275
Sarah Penfold, Emily St. Denis, Mir Nadeem Mazhar
British Journal of Psychiatry Open Sep 2016, 2 (4) 275-279;
DOI: 10.1192/bjpo.bp.115.002808

Abstract
Background Overlap of aetiological factors and demographic characteristics with clinical observations of comorbidity has been documented in fibromyalgia syndrome, chronic fatigue syndrome (CFS) and borderline personality disorder (BPD).

Aims The purpose of this study was to assess the association of BPD with fibromyalgia syndrome and CFS. The authors reviewed literature on the prevalence of BPD in patients with fibromyalgia or CFS and vice versa.

Methods A search of five databases yielded six eligible studies. A hand search and contact with experts yielded two additional studies. We extracted information pertaining to study setting and design, demographic information, diagnostic criteria and prevalence.

Results We did not identify any studies that specifically assessed the prevalence of fibromyalgia or CFS in patients with BPD. Three studies assessed the prevalence of BPD in fibromyalgia patients and reported prevalence of 1.0, 5.25 and 16.7%. Five studies assessed BPD in CFS patients and reported prevalence of 3.03, 1.8, 2.0, 6.5 and 17%.

Conclusions More research is required to clarify possible associations between BPD, fibromyalgia and CFS.

Declaration of interest None.

Copyright and usage © The Royal College of Psychiatrists 2016.

Until more evidence is presented to either support or refute possible associations between the disorders of interest, the authors will continue to maintain an index of clinical suspicion for conditions such as fibromyalgia and CFS in patients with BPD as part of a thorough psychiatric assessment.

 

[TiredSam]

Conclusions More research is required to clarify possible associations between BPD, fibromyalgia and CFS.

Despite their best efforts they found nothing, but will keep trying.

What motivates people like this?

And what is an "index of clinical suspicion"?

 

[sarah darwins]

More Snark-hunting ....

 

[Invisible Woman]

When will the psychs finally accept that it's ALL IN THEIR MINDS!

 

[Chrisb]

Is it some borderline personality disorder that prevents some researchers dealing with patients with the conditions supposedly being researched?

Methods A search of five databases yielded six eligible studies. A hand search and contact with experts yielded two additional studies. We extracted information pertaining to study setting and design, demographic information, diagnostic criteria and prevalence.

So that's all right then.

 

[Undisclosed]

What motivates people like this?

Irrational delusions.

 

[Sean]

Until more evidence is presented to either support or refute possible associations between the disorders of interest, the authors will continue to maintain an index of clinical suspicion for conditions such as fibromyalgia and CFS in patients with BPD as part of a thorough psychiatric assessment.

Guilty until proven innocent.

SNAFU

 

[SilverbladeTE]

Irrational delusions.

true
and in some cases, bloody minded rat bastardy!

 

[user9876]

For the 5 CFS studies they quote they have one at 17% but with only 35 patients. Others are much less. The abstract of this 17% study says

This study investigated the relative rates of personality disturbance in chronic fatigue syndrome (CFS). Individuals who met the CDC criteria for CFS were compared to two other fatiguing illness groups, mild multiple sclerosis and depression, as well as sedentary healthy controls. Subjects were administered a structured psychiatric interview to determine Axis I psychiatric disorders and two self-report instruments to assess Axis II personality disorders and the personality trait of neuroticism. The depressed group had significantly more personality disorders and elevated neuroticism scores compared with the other three groups. The CFS and MS subjects had intermediary personality scores which were significantly higher than healthy controls. The CFS group with concurrent depressive disorder (34% of the CFS group) was found to account for most of the personality pathology in the CFS sample. The results are discussed in the context of the relationship between personality variables and fatiguing illnes

From comments in the review about this study:

The prevalence of BPD was found to be 17% in those with CFS, 25% in patients with multiple sclerosis, 29% in control patients with depression and 0% in healthy controls

So it looks to me as if the questions they ask to claim BPD may just have answers that come with fatigue (suggested by increase in MS and CFS). Also it is unclear how to disentangle depression from ME. This is also the smallest study with 34 patients.

For another study they comment

The 2010 population-based study by Nater et al compared the prevalence of personality disorders and traits of survey respondents meeting criteria for CFS versus respondents with ‘insufficient fatigue’ and ‘well’ respondents. The authors found that the prevalence of BPD was 1.8% among those with CFS, 0.4% among those with fatigue who did not meet criteria for CFS and 0% among those identified as well.26

This was a larger study with 113 patients. But I do wonder if the questionnaires are just picking up effects of being ill. This study found the smallest number of people with BPD.

With this study of 50 patients the numbers with BPD were smaller than the healthy population. There healthy population figure is high at 6% which is as high.

The 2009 study by Courjaret et al assessed the prevalence of personality disorders in a sample of female CFS patients compared with two control groups (psychiatric and general population controls).25 The study found that the prevalence of BPD was 2, 42 and 6% in the CFS, psychiatric and general population groups, respectively.25

But the 6% figure for controls is similar to this study (92 patients) which has the same level for CFS.

The prevalence of BPD was found to be 6.5% in patients with CFS, 6.5% in the community control group and 39.1% in the psychiatric patient control group.27

So looking at this I would conclude there is nothing worth looking at. Certainly not worth research dollars being diverted to this rather than promising research lines.

 

[Denise]

"Until more evidence is presented to either support or refute possible associations between the disorders of interest, the authors will continue to maintain an index of clinical suspicion for conditions such as fibromyalgia and CFS in patients with BPD as part of a thorough psychiatric assessment."

Oh Good Grief!
When will these claims end?
How much biological proof do these people NEED?

 

[TiredSam]

Oh Good Grief!
When will these claims end?
How much biological proof do these people NEED?

They are completely immune to any amount of proof. All we need is enough proof for the rest of the world to realize what complete nonsense they are babbling. At that point they will be sidelined and ignored. Then they'll get bored and move on to their next victims (ie sufferers of another unexplained illness). That is why it is so important that they are brought to account and this madness is stopped instead of being rewarded with knighthoods.

 

[A.B.]

What's the name of the personality disorder in which there is an emotional need to build a narrative of moral failure in patients with poorly understood disease?

It's always the most vulnerable patient populations that are targeted. Some sort of a bullying phenomenon.

 

[Sidereal]

BPD is fairly common in the population. If you exclude the clearly invalid tiny study that showed 17% prevalence rate, the rate of BPD in the other CFS studies is just what you'd expect in any population. Their conclusion is puzzling/absurd. I'm surprised that no reviewer pointed this out.

 

[Large Donner]

I am not sure they will only move onto other groups. This study also used people with MS and seems to have made the same basic flawed assesments of that biological illness.

ie/ Feel ill?

Yes..

Ah look your "behaviour" has changed therefore you have a co morbid personality disorder.

Dont forget this study claims to be looking at comorbid issues not primary cause. Its obvious though that the intention is to imply "BPD" as causative and hidden. It s a game that ca go on and on.

The next stage is obvious when biomarkers are found for the cause of the physical disease, they will start a whole new round of "we have discovered the biomarkers for the mental function change in ......".

Feeling ill is a personality disorder!!

 

[Cheshire]

Their conclusion is puzzling/absurd. I'm surprised that no reviewer pointed this out.

Why am I not?

 

[Sidereal]

Natelson was the senior author of the 17% study, btw. I've always considered him a wolf in sheep's clothing.

 

[Sidereal]

Why am I not?

I guess I should be used to it by now. As you can see this paper was published in BJP Open. A lot of major journals like BJP, BMJ, various Nature journals etc. have started these new Open journals which will literally publish any old piece of trash for a payment, the stuff that's not good enough for their reputable flagship journals. It's a money-making racket for them but as a consequence of these predatory publishing practices we're now in a situation where virtually everything on Pubmed is wrong and extremely poor quality research like this review is not just slipping through the peer-review cracks every once in a while but becoming the norm.

 

[soti]

never mind the problematic assumptions behind BPD itself...

https://www.academia.edu/2080856/Bo...Patriarchal_Boundaries_of_Sanity_Self_and_Sex
http://www.ssa.uchicago.edu/power-s...nist-critique-borderline-personality-disorder
http://www.vanderbilt.edu/rpw_center/newsletter/Letters_Spring14.pdf

ah, crazy women... where would the psychiatric profession be without them/us?

 

[Bob]

I was going to comment on this study, but gave up in exasperation! (It's possibly best to ignore it anyway!)

This paper is basically trolling the patient community via academic publication? Is there a word for that?

 

[Sidereal]

The editor of this journal is from QMUL btw.