Are people being misdiagnosed with Borderline Personality Disorder instead of autism?

A man looking at a moving train carriage

 

A new study has shown that there is an overlap in the behaviour traits of people diagnosed with Borderline Personality Disorder (BPD) and Autism Spectrum Conditions (or autism for short). This could mean many people may be receiving the wrong diagnosis and not getting the right support.

The study was funded by the Autism Research Trust and was carried out by a team at the Autism Research Centre at Cambridge University. It was led by Dr Robert Dudas, Visiting Researcher at the Department of Psychiatry. You can download the paper here.

The team compared data collected from different groups of people. One group had a diagnosis of autism, a second group had Borderline Personality Disorder, and a third group had been diagnosed with both conditions. A final group served as a control group of neurotypical individuals.

Participants completed an online survey and three kinds of traits were compared across the groups: ‘autistic traits’, the ability to empathise, and the ability to systemize.

Learning about the two conditions

Dudas and his team expected to find some similarities between the two conditions, as both autistic people and people with BPD can find social interactions challenging.

However, as well as similarities in social behaviour, the team found an interesting overlap in systemizing, which is a person’s drive to find logical patterns and rules in the world. This finding is interesting, because it means that people with these conditions not only have difficulties (in dealing with the social world), but also have strengths: both groups have above average systemizing abilities.

This is the first time that systemizing has been tested in people with BPD and the team were surprised at what they found,

“We didn’t expect the Borderline group to score just as high as the autistic group.” says Dudas, who hopes that finding new areas of overlap in these conditions could lead to new ways of approaching how the conditions are diagnosed and treated.

The importance of diagnosis

Dr Dudas had met patients with BPD who believed they were misdiagnosed, often claiming they were, in fact, bipolar. But in recent times he has increasingly met patients who believe themselves to have autism.

“I think in a number of cases, that is true. They may have been misdiagnosed”, he said.

One important conclusion of this work, Dudas believes, is that clinicians need to be made aware of this overlap to avoid further misdiagnosis. The overlap between autism and BPD is not only possible, but is more common than previously thought. Some people have both conditions.

“Patients have been saying this for a long time and it’s really important to do some more detailed studies to look into this.”

“Nobody meets a textbook definition of a condition,” Dudas explains, as he describes how important it is that clinicians now look to re-examine how they make a diagnosis.

The next step in this research is to replicate the findings with larger set of data. “Systemizing and empathy might be areas we can measure reliably, and we might be able to reduce the rate of misdiagnosis. And these new methods might lead to changing concepts of disorders.”

Supporting more research

At the Autism Research Trust we believe that research is key to improve the quality of life of autistic people and their families. If you wish to support more research like that of Dr. Robert Dudas, please donate online today. Thank you.