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Clinical characteristics were compared in patients with (<jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>+) and without (<jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\u2212) comorbid <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> and in <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>+ with (<jats:styled-content style=\"fixed-case\">MXS<\/jats:styled-content>+) and without (<jats:styled-content style=\"fixed-case\">MXS<\/jats:styled-content>\u2212) mixed features according to <jats:styled-content style=\"fixed-case\">DSM<\/jats:styled-content>\u20105 criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 187 patients (6.7%) met the criteria for <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>. A <jats:styled-content style=\"fixed-case\">DSM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TR<\/jats:styled-content> diagnosis of bipolar disorder (<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>) was significantly more frequent in patients with <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>+ than in patients with <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>. Patients with BPD+ were significantly younger and reported lower age at onset than <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\u2212. Patients with BPD+ also showed more hypomania\/mania in first\u2010degree relatives in comparison with patients with <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>\u2212, as well as more psychiatric comorbidity, mixed features, atypical features, suicide attempts, prior mood episodes and antidepressant\u2010induced hypo\/manic switches. Mixed features according to <jats:styled-content style=\"fixed-case\">DSM<\/jats:styled-content>\u20105 criteria were observed in 52 (27.8%) <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content>+. In comparison with <jats:styled-content style=\"fixed-case\">MXS<\/jats:styled-content>\u2212, <jats:styled-content style=\"fixed-case\">MXS<\/jats:styled-content>+ were significantly younger at age of onset and at prior mood episode and had experienced more mood episodes and hypo\/manic switches with antidepressant treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Major depressive episode patients with comorbid <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> reported a high prevalence of mixed features and <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>. The presence of <jats:styled-content style=\"fixed-case\">DSM<\/jats:styled-content>\u20105 mixed features in <jats:styled-content style=\"fixed-case\">MDE<\/jats:styled-content> patients with <jats:styled-content style=\"fixed-case\">BPD<\/jats:styled-content> may be associated with complex course and reduced treatment response.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.12457","type":"journal-article","created":{"date-parts":[[2015,6,12]],"date-time":"2015-06-12T15:09:13Z","timestamp":1434121753000},"page":"133-143","source":"Crossref","is-referenced-by-count":29,"title":["Relationships between mixed features and borderline personality disorder in 2811 patients with major depressive episode"],"prefix":"10.1111","volume":"133","author":[{"given":"G.","family":"Perugi","sequence":"first","affiliation":[{"name":"University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Angst","sequence":"additional","affiliation":[{"name":"Psychiatrische Universit\u00e4tsklinik Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u2010M.","family":"Azorin","sequence":"additional","affiliation":[{"name":"H\u00f4pital Sainte\u2010Marguerite Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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