{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:07:32Z","timestamp":1790114852829,"version":"4.0.1"},"reference-count":61,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T00:00:00Z","timestamp":1516838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>A high incidence of Axis <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> personality disorders is described in patients with bipolar disorder; however, their relationship to mood state remains uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 966 outpatients with bipolar disorder gave informed consent and filled out the Personality Disorder Questionnaire, 4th edition (<jats:styled-content style=\"fixed-case\">PDQ<\/jats:styled-content>4) and a questionnaire on demographics and course of illness prior to Bipolar Treatment Outcome Network entry at average age 41 years. Patients were rated at each visit for depression on the Inventory of Depressive Symptoms\u2010Clinician version (<jats:styled-content style=\"fixed-case\">IDS<\/jats:styled-content>\u2010C) and for mania on the Young Mania Rating Scale (<jats:styled-content style=\"fixed-case\">YMRS<\/jats:styled-content>). In a subgroup, the <jats:styled-content style=\"fixed-case\">PDQ<\/jats:styled-content>4 was retaken during periods of depression and euthymia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients met criteria for most personality disorders at a much higher rate when they took the <jats:styled-content style=\"fixed-case\">PDQ<\/jats:styled-content>4 while depressed compared to while euthymic, and scores were significantly related to the severity of depression (<jats:styled-content style=\"fixed-case\">IDS<\/jats:styled-content>) and of mania (<jats:styled-content style=\"fixed-case\">YMRS<\/jats:styled-content>) assessed within 2 weeks of taking the <jats:styled-content style=\"fixed-case\">PDQ<\/jats:styled-content>. Even when euthymic, more than quarter to half of the patients met criteria for a cluster A, B or C personality disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A wide range of personality disorders occur in bipolar patients, but are highly dependent on filling out the form while depressed compared to while euthymic. How this relates to having a personality disorder assessed using a structured clinical interview remains to be tested. However, higher <jats:styled-content style=\"fixed-case\">PDQ<\/jats:styled-content>4 scores are related to an earlier age of onset of bipolar disorder and other factors portending a more difficult course of bipolar disorder, and the optimal treatment of these patients remains to be illuminated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12596","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T11:56:55Z","timestamp":1516881415000},"page":"303-312","source":"Crossref","is-referenced-by-count":21,"title":["Prevalence of axis <scp>II<\/scp> comorbidities in bipolar disorder: relationship to mood state"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4246-524X","authenticated-orcid":false,"given":"Robert M","family":"Post","sequence":"first","affiliation":[{"name":"Bipolar Collaborative Network  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele S","family":"Leverich","sequence":"additional","affiliation":[{"name":"Bipolar Collaborative Network  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"McElroy","sequence":"additional","affiliation":[{"name":"Linder Center of Hope  Mason OH USA"},{"name":"Biological Psychiatry Program University of Cincinnati Medical College  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Kupka","sequence":"additional","affiliation":[{"name":"Department of Psychiatry VU University Medical Center  Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trisha","family":"Suppes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine and V.A. 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