Shea M Tracie, Stout Robert, Gunderson John, Morey Leslie C, Grilo Carlos M, McGlashan Thomas, Skodol Andrew E, Dolan-Sewell Regina, Dyck Ingrid, Zanarini Mary C, Keller Martin B
Department of Psychiatry and Human Behavior, Brown University Medical School, Duncan Building, 700 Butler Drive, Providence, RI 20906, USA.
Am J Psychiatry. 2002 Dec;159(12):2036-41. doi: 10.1176/appi.ajp.159.12.2036.
Personality disorders are defined as enduring patterns of maladaptive behaviors and traits that are stable over time. This study prospectively examined the stability of four personality disorders (schizotypal, borderline, avoidant, and obsessive-compulsive) over a 1-year follow-up period.
Subjects (N=668) were recruited from multiple clinical settings at four collaborating institutions. Subjects met criteria for one or more of the four personality disorders or were part of a comparison group of subjects with major depressive disorder and no personality disorder. Diagnoses were established by using semistructured interviews. Follow-up assessments, conducted 6 and 12 months after the baseline assessment, included monthly ratings of all criteria for the four personality disorders and weekly ratings of the course of major depressive disorder. The current report is based on 621 subjects with complete data through 12 months of the follow-up period.
Significantly more subjects in each personality disorder group remained at diagnostic threshold throughout the 12 months of the follow-up period than did those in the major depressive disorder group. A continuous measure of number of criteria met was highly correlated across the three assessments. The majority of personality disorder subjects, however, did not consistently remain at diagnostic threshold, and the mean number of criteria met decreased significantly for each group.
Individual differences in personality disorder features appear to be highly stable, although the number of criteria present decreases over time. Personality disorders may be characterized by stable trait constellations that fluctuate in degree of maladaptive expression.
人格障碍被定义为适应不良行为和特质的持久模式，且随时间保持稳定。本研究前瞻性地考察了四种人格障碍（分裂型、边缘型、回避型和强迫型）在1年随访期内的稳定性。
从四个合作机构的多个临床环境中招募受试者（N = 668）。受试者符合四种人格障碍中一种或多种的标准，或为重度抑郁症且无人格障碍的对照组受试者。通过半结构化访谈进行诊断。在基线评估后6个月和12个月进行随访评估，包括对四种人格障碍所有标准的月度评分以及对重度抑郁症病程的每周评分。本报告基于随访期12个月内有完整数据的621名受试者。
在随访期的12个月内，各人格障碍组中始终处于诊断阈值的受试者显著多于重度抑郁症组。在三次评估中，满足标准数量的连续测量结果高度相关。然而，大多数人格障碍受试者并非始终处于诊断阈值，且每组满足标准的平均数量显著下降。
人格障碍特征的个体差异似乎高度稳定，尽管随着时间推移满足的标准数量会减少。人格障碍可能以稳定的特质组合为特征，这些特质组合在适应不良表达的程度上有所波动。
