Introduction to Bipolar Disorder

Photo Credit: Cleveland Clinic 

Photo Credit: Cleveland Clinic 


          Bipolar disorder is a manic-depressive mental disorder that affects one’s mood, behavioral, and activity levels. There are four types of bipolar disorders: bipolar I, bipolar II, cyclothymic, and unspecified bipolar disorder. Bipolar I disorder is a diagnosis of individuals who experience periods of manic behavior that last approximately one week, and it is so severe that he or she may need hospitalization. For this type of disorder, individuals also experience depressive episodes that can last approximately half a month. People who are diagnosed with Bipolar II disorder experience manic and depressive behaviors, but are as not as severe as Bipolar I. 

          Cyclothymic disorder is when a person suffers multiple episodes of manic and depressive-like behavior for at least two years in adults and approximately one year for children. However, the disorder does not meet medical requirements, which constitute hypomanic and depressive behavior for the first two types of bipolar disorder. Finally, unspecified types of bipolar disorder is seen in people who experience symptoms of the disorder, but are not relevant to the three types mentioned. Bipolar disorder can be difficult to diagnose, as symptoms can be challenging to detect. Trained professionals state there are red flags to determine if an individual should seek treatment. Currently, there is not a cure for the disorder, but can be controlled with medication and therapy. 

Prevalence of Axis II Comorbities in Bipolar Disorder: Relationship to Mood State

            The article chosen discusses how Axis II personality disorders are correlated to individuals diagnosed with bipolar disorder; however, there are some discrepancies that provoked the study. The correlation between the personality and bipolar disorders and behaviors is not clear and testing needed to be completed to determine if there is definitive evidence (Post et al., 2018). Axis II personality disorders consist of the following: antisocial, avoidant, borderline, dependent, histrionic, mental retardation, narcissistic, obsessive-compulsive, paranoid, personality, schizoid, and schizotypal. These disorders are predicated on social, personality, and intellectual disabilities. Based on the information given, those diagnosed with personality disorders are known to have bipolar disorder as well. 


            Nine hundred and sixty-six 41-year-olds, who were diagnosed with bipolar disorder, participated in the study and completed the fourth edition Personality Disorder Questionnaire (PDQ4), which is significantly used to identify personality disorders. Participants also received a demographical questionnaire to discuss their socioeconomic status and population structures and a Bipolar Treatment Outcome Network, which was established to improve discrepancies within research for bipolar cases. After completing the survey, individuals were evaluated for depression and mania using the Inventory of Depressive Symptoms-Clinician and Young Mania Rating Scale assessments (Post et al., 2018). The Inventory of Depressive Symptoms-Clinician survey is a 30-question assessment, which was established by the American Psychiatry Association Diagnostic and Statistical Manual of Mental Disorders (fourth edition) as a basis for determining depressive indicators. The Young Mania Rating Scale is a self-administered survey to identify bouts of hysteria. A secondary group (participants who initially took the PDQ4 assessment among the 966) was selected to take the PDQ4 assessment when he or she experienced periods of depression and/or composed behaviors. 


            The results showed participants at a higher rate for most personality disorders when they took the PDQ4 assessment while in a depressive state versus tranquil moods. The researchers believed the scores on the assessments were directly correlated to increase bouts of depression and hysteria, which were predicated on the Inventory of Depressive Symptoms-Clinician and Young Mania Rating Scale assessments. The episodes of manic-depression and the analysis conducted were based on a two-week period, which conferred after the PDQ4 assessment (Post et al., 2018). Finally, researchers found that up to half of the participant population were candidates for specific personality disorders. 


          The purpose of the research study to see if there was a parallel between personality and bipolar disorders. Researchers wanted to examine if bipolar disorder displayed other conditions that affect mood, behaviors, and social activity. Based on the article, Post and his colleagues believe those who are diagnosed with Axis II personality disorders also have bipolar disorder based on the multiple assessment given during the experimental research study. Their claims are such patients are “highly dependent” on completing the assessment while in a depressive state rather than a tranquil mood (Post et al., 2018). It is believed that completing the assessments in such a state affects the analysis and results of patients’ behavioral information. That is why ambiguity remains if true behaviors and symptoms of indicative of bipolar disorder. However, it is believed the PDQ4 evaluation For recommendation for future studies, the researchers believe the correlation to personality disorders evaluated during the assessment should be evaluated by structured clinical interview process. 


Post, R. M., Leverich, G. S., McElroy, S., Kupka, R., Suppes, T., Altshuler, L., Nolen, W., Frye, M., Keck, P., Grunze, H., & Hellemann, G. (2018). Prevalence of aix II comorbities in bipolar disorder: Relationship to mood state. John Wiley & Sons Online Library. Retrieved from (accessed on 16 June 2018).