Interconnectedness of borderline personality pathology and affective temperaments in patients with mood disorders: a network analysis

Purpose: Mood disorders frequently coexist with borderline personality pathology (BPP), presenting considerable clinical challenges. Affective temperaments (AT) play a role in modulating mood disorders and influence the manifestation of illness. BPP and AT share common characteristics, such as emotional instability, impulsivity, and difficulties in interpersonal relationships. However, research on the relationship between BPP and AT remains limited. This study employed network analysis to explore the network structure between BPP and AT in a cohort of patients with mood disorders.

Materials and methods: A total of 720 patients with mood disorders (major depressive disorder, n = 267; bipolar affective disorder, n = 453) were included in the analysis. The Personality Assessment Inventory-Borderline Features Scale (PAI-BOR) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire short version (TEMPS-A) were utilized. Network analysis was conducted to identify central symptoms and network structures across the five AT dimensions and 24 BPP items.

Results: The BPP and TEMPS-A items were intricately interwoven, with no distinct groupings. The most significant symptoms identified were "Mood shifts" and "Cyclothymic temperament." Additionally, irritable temperament was strongly linked to "Little control over anger," while anxious temperament was closely associated with "Worry about people leaving."

Conclusion: The overlap of BPP and AT in the network, without a clear separation, suggests a significant interconnection between these clinical concepts. The centrality of "Mood shifts" and "Cyclothymic temperament" in this network underscores the importance of targeting these symptoms in the treatment of patients with prominent BPP and AT.