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The borderline of bipolar: opinions of patients and lessons for clinicians on the diagnostic conflict

  • Emma Richardson (a1) (a2) and Derek K. Tracy (a1) (a2)
Abstract
Aims and method

It has been observed that some individuals self-diagnose with a bipolar affective disorder and many are later diagnosed with a borderline personality disorder. There is a background context of clinical and neurobiological overlap between these conditions, and fundamental debates on the validity of current diagnostic systems. This qualitative study is the first work to explore the views of patients caught at this diagnostic interface. We predicted that media exposure, stigma and attribution of responsibility would be key factors affecting patient understanding and opinion.

Results

Six core illness-differentiating themes emerged: public information, diagnosis delivery, illness causes, illness management, stigma, and relationship with others. Individuals did not ‘want’ to be diagnosed with a bipolar disorder, but wished for informed care.

Clinical implications

Understanding patient perspectives will allow clinical staff to better appreciate the difficulties faced by those we seek to help, identify gaps in care provision, and should stimulate thought on our attitudes to care and how we facilitate provision of information, including information about diagnosis.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Derek Tracy (derek.tracy@oxleas.nhs.uk)
Footnotes
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Declaration of interest

None.

Footnotes
References
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The borderline of bipolar: opinions of patients and lessons for clinicians on the diagnostic conflict

  • Emma Richardson (a1) (a2) and Derek K. Tracy (a1) (a2)
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