Regarding treatment utilization, our study noted that 2.3% of bipolar patients with comorbid BPD utilized ECT and had a 1.4-fold higher likelihood of receiving inpatient ECT. This may be partly attributed to the higher prevalence of suicidal ideations, and ECT is one of the most effective treatments for the management of suicidal depression [21]. We also noted that the use of ECT was associated with higher healthcare costs due to extended LOS. With recent advances in pharmacogenetic testing (PGT), a study conducted by Ielmini et al. found it to be an effective and individualized therapeutic measure for managing patients with bipolar disorder. About 40% of a patient’s regimen was changed based upon the PGT results with a significant clinical improvement at the three-month follow-up (p = 0.001) [22]. There is a need to evaluate if PGT can be efficacious in managing patients with comorbid mental illness like BPD.
