George Elizabeth L, Miklowitz David J, Richards Jeffrey A, Simoneau Teresa L, Taylor Dawn O
Department of Psychology, University of Colorado, Boulder, CO 80309-0345, USA.
Bipolar Disord. 2003 Apr;5(2):115-22. doi: 10.1034/j.1399-5618.2003.00028.x.
Many studies have examined the prevalence and predictive validity of axis II personality disorders among unipolar depressed patients, but few have examined these issues among bipolar patients. The few studies that do exist suggest that axis II pathology complicates the diagnosis and course of bipolar disorder. This study examined the prevalence of axis II disorder in bipolar patients who were clinically remitted.
We assessed the co-occurrence of personality disorder among 52 remitted DSM-III-R bipolar patients using a structured diagnostic interview, the Personality Disorder Examination (PDE).
Axis II disorders can be rated reliably among bipolar patients who are in remission. Co-diagnosis of personality disorder occurred in 28.8% of patients. Cluster B (dramatic, emotionally erratic) and cluster C (fearful, avoidant) personality disorders were more common than cluster A (odd, eccentric) disorders. Bipolar patients with personality disorders differed from bipolar patients without personality disorders in the severity of their residual mood symptoms, even during remission.
When structured assessment of personality disorder is performed during a clinical remission, less than one in three bipolar patients meets full syndromal criteria for an axis II disorder. Examining rates of comorbid personality disorder in broad-based community samples of bipolar spectrum patients would further clarify the linkage between these sets of disorders.
许多研究已探讨了单相抑郁患者中轴II人格障碍的患病率及预测效度，但极少有研究在双相情感障碍患者中探讨这些问题。现有的少数研究表明，轴II病理改变使双相情感障碍的诊断及病程复杂化。本研究调查了临床缓解的双相情感障碍患者中轴II障碍的患病率。
我们使用结构化诊断访谈——人格障碍检查（PDE），评估了52例已缓解的DSM-III-R双相情感障碍患者中人格障碍的共病情况。
轴II障碍在缓解期双相情感障碍患者中可得到可靠评定。人格障碍的共病诊断发生在28.8%的患者中。B类（戏剧性、情绪不稳定）和C类（恐惧、回避型）人格障碍比A类（古怪、怪异）障碍更常见。即使在缓解期，患有人格障碍的双相情感障碍患者与未患有人格障碍的双相情感障碍患者在残留情绪症状的严重程度上也有所不同。
在临床缓解期对人格障碍进行结构化评估时，不到三分之一的双相情感障碍患者符合轴II障碍的完整综合征标准。在双相谱系障碍患者的广泛社区样本中检查共病性人格障碍的发生率，将进一步阐明这两组障碍之间的联系。
