Coid J W
Academic Section of Forensic Psychiatry, St Bartholomew's and the Royal London School of Medicine and Dentistry, John Howard Centre.
Br J Psychiatry. 1999 Jun;174:530-8. doi: 10.1192/bjp.174.6.530.
Elucidation of aetiological processes leading to development of Axis II disorders is important in category validation and could lead to new treatments.
To establish aetiological associations between Axis II disorders and specific risk factors.
Male and female subjects (n = 260) in maximum security hospitals and prisons were interviewed to determine DSM-III Axis II and lifetime Axis I diagnoses. Aetiological risk factors were obtained at interview and from case files. Independent statistical associations were established by logistic regression.
Axis II categories were divided into four groups: (a) disorders of character development, secondary to an adverse early environment: antisocial, self-defeating and paranoid; (b) disorders of temperament, secondary to constitutional aetiology: avoidant, dependent, schizoid and schizotypal; (c) a 'mixed' disorder of constitutional and environmental aetiology: borderline; and (d) aetiological associations not established: narcissistic, histrionic, compulsive and passive-aggressive.
The study validates several Axis II categories but challenges the inclusion of others within Axis II of DSM-IV, in particular schizoid, schizotypal, avoidant and borderline personality disorders. The findings have implications for future treatment interventions.
阐明导致轴II障碍发展的病因过程对于类别验证很重要，并且可能带来新的治疗方法。
建立轴II障碍与特定风险因素之间的病因学关联。
对戒备森严的医院和监狱中的男性和女性受试者（n = 260）进行访谈，以确定DSM-III轴II和终生轴I诊断。在访谈时以及从病例档案中获取病因风险因素。通过逻辑回归建立独立的统计关联。
轴II类别分为四组：（a）性格发展障碍，继发于不良早期环境：反社会型、自我挫败型和偏执型；（b）气质障碍，继发于体质病因：回避型、依赖型、分裂样和分裂型；（c）体质和环境病因的“混合”障碍：边缘型；以及（d）未建立病因学关联：自恋型、表演型、强迫型和被动攻击型。
该研究验证了几个轴II类别，但对将其他类别纳入DSM-IV轴II提出了挑战，特别是分裂样、分裂型、回避型和边缘型人格障碍。这些发现对未来的治疗干预有影响。
