Zimmerman M, Mattia J I
Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence, USA.
Compr Psychiatry. 1999 Jul-Aug;40(4):245-52. doi: 10.1016/s0010-440x(99)90123-2.
Borderline personality disorder (PD) has been the most studied PD. Research has examined the relationship between borderline PD and most axis I diagnostic classes such as eating disorders, mood disorders, and substance use disorders. However, there is little information regarding the relationship of borderline PD and overall comorbidity with all classes of axis I disorders assessed simultaneously. In the present study, 409 patients were evaluated with semistructured diagnostic interviews for axis I and axis II disorders. Patients with a diagnosis of borderline PD versus those who did not receive the diagnosis were assigned significantly more current axis I diagnoses (3.4 v 2.0). Borderline PD patients were twice as likely to receive a diagnosis of three or more current axis I disorders (69.5% v 31.1%) and nearly four times as likely to have a diagnosis of four or more disorders 147.5% v 13.7%). In comparison to nonborderline PD patients, borderline PD patients more frequently received a diagnosis of current major depressive disorder (MDD), bipolar I and II disorder, panic disorder with agoraphobia, social and specific phobia, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), eating disorder NOS, and any somatoform disorder. Similar results were observed for lifetime diagnoses. Overall, borderline PD patients were more likely to have multiple axis I disorders than nonborderline PD patients, and the differences between the two groups were present across mood, anxiety, substance use, eating, and somatoform disorder categories. These findings highlight the importance of performing thorough evaluations of axis I pathology in patients with borderline PD in order not to overlook syndromes that are potentially treatment-responsive.
边缘型人格障碍（BPD）是研究最多的人格障碍。研究已经考察了边缘型人格障碍与大多数轴I诊断类别之间的关系，如饮食失调、情绪障碍和物质使用障碍。然而，关于边缘型人格障碍与同时评估的所有轴I障碍类别的总体共病关系的信息却很少。在本研究中，对409名患者进行了轴I和轴II障碍的半结构化诊断访谈评估。被诊断为边缘型人格障碍的患者与未接受该诊断的患者相比，当前轴I诊断显著更多（3.4比2.0）。边缘型人格障碍患者被诊断患有三种或更多当前轴I障碍的可能性是未患该障碍患者的两倍（69.5%比31.1%），被诊断患有四种或更多障碍的可能性几乎是未患该障碍患者的四倍（47.5%比13.7%）。与非边缘型人格障碍患者相比，边缘型人格障碍患者更频繁地被诊断患有当前的重度抑郁症（MDD）、双相I型和II型障碍、伴有广场恐惧症的惊恐障碍、社交和特定恐惧症、创伤后应激障碍（PTSD）、强迫症（OCD）、未特定的饮食失调以及任何躯体形式障碍。终生诊断也观察到了类似结果。总体而言，边缘型人格障碍患者比非边缘型人格障碍患者更有可能患有多种轴I障碍，并且两组之间的差异存在于情绪、焦虑、物质使用、饮食和躯体形式障碍类别中。这些发现凸显了对边缘型人格障碍患者进行轴I病理全面评估的重要性，以免忽视可能对治疗有反应的综合征。
