We conducted a secondary analysis of data from a clinical trial to explore the relationship between degree of personality disorder (PD) pathology (i.e., number of subthreshold and threshold PD symptoms) and mood and functioning outcomes in Bipolar I Disorder (BD-I). Ninety-two participants completed baseline mood and functioning assessments and then underwent 4 months of treatment for an index manic, mixed, or depressed phase acute episode. Additional assessments occurred over a 28-month follow-up period. PD pathology did not predict psychosocial functioning or manic symptoms at 4 or 28 months. However, it did predict depressive symptoms at both timepoints, as well as percent time symptomatic. Clusters A and C pathology were most strongly associated with depression. Our findings fit with the literature highlighting the negative repercussions of PD pathology on a range of outcomes in mood disorders. This study builds upon previous research, which has largely focused on major depression and which has primarily taken a categorical approach to examining PD pathology in BD. 1. Introduction Research suggests that comorbid personality disorder (PD) pathology has negative repercussions across a range of psychological disorders and for a variety of outcomes [1]. Within this body of literature, affective disorders have received a great deal of attention, with perhaps the largest number of studies focusing on major depressive disorder (MDD). Although some findings have been inconsistent [2], the majority of research has found adverse effects of PD pathology on the course of MDD [3–6] and on functional and symptomatic outcomes [7–11]. Relatively fewer studies have explored the impact of PD pathology on outcomes in bipolar disorder (BD), despite published comorbidity rates that range from 12% to 89% [12]. Overall, the literature suggests similar patterns as are evident in MDD. Compared to those without comorbid PD diagnoses, patients with BD and comorbid PDs have higher rates of hospitalization [13], suicide attempts and ideation [14, 15], psychosocial service utilization [16], and alcohol and substance abuse [17, 18]. They also have shown worse functional and symptomatic outcomes [19, 20] and poorer medication compliance and response [13, 21] in some studies. Given overlapping clinical features, a number of studies have focused specifically on the effects of comorbid borderline personality disorder (BPD) in individuals with BD. Compared to those without such comorbidity, patients with BD and BPD have higher rates of psychotic symptoms during mood episodes [22],
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