Seivewright Helen, Tyrer Peter, Johnson Tony
Department of Public Mental Health, Imperial College of Science, Technology, and Medicine and Medical Research Council Unit, Cambridge, UK.
Lancet. 2002 Jun 29;359(9325):2253-4. doi: 10.1016/S0140-6736(02)09266-8.
Personality disorders are generally thought not to change by much over time. We assessed the personality status of 202 patients who had a defined diagnostic and statistical manual (DSM)-III neurotic disorder, dysthymia, panic disorder, or generalised anxiety. All patients had had drug and psychological treatment in a randomised controlled trial. 12 years after entry to the study, we reassessed the personality status of 178 (88%) of these patients using the same test (personality assessment schedule). The personality traits of patients in the cluster B flamboyant group (antisocial, histrionic) became significantly less pronounced over 12 years, but those in the cluster A odd, eccentric group (schizoid, schizotypal, paranoid), and the cluster C anxious, fearful group (obsessional, avoidant) became more pronounced. The measure of agreement between baseline and 12-year personality clusters was poor or slight (kappa=0.14, 95% CI 0.04-0.23). Our results suggest that the assumption that personality characteristics do not change with time is incorrect.
人格障碍通常被认为不会随时间发生太大变化。我们评估了202例患有明确诊断和统计手册（DSM）-III神经症、心境恶劣、惊恐障碍或广泛性焦虑症的患者的人格状况。所有患者均在一项随机对照试验中接受了药物和心理治疗。进入研究12年后，我们使用相同的测试（人格评估量表）对其中178例（88%）患者的人格状况进行了重新评估。B类浮夸组（反社会型、表演型）患者的人格特质在12年中变得明显不那么突出，但A类古怪、怪异组（分裂样、分裂型、偏执型）以及C类焦虑、恐惧组（强迫型、回避型）患者的人格特质则变得更加突出。基线和12年人格类型之间的一致性衡量较差或轻微（kappa = 0.14，95%CI 0.04 - 0.23）。我们的结果表明，人格特征不会随时间变化的假设是不正确的。
