Barnow S, Rüge J, Spitzer C, Freyberger H-J
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ernst-Moritz-Arndt-Universität Greifswald im Klinikum Stralsund.
Nervenarzt. 2005 Jul;76(7):839-40, 842-4, 846-8. doi: 10.1007/s00115-004-1810-8.
High comorbidity, suicidal ideation, difficult temperament, and character are key symptoms of persons with borderline personality disorder (BPD). We investigated 478 persons, 40 of whom had a BPD according SCID-II, self-rating. Participants were examined with a semistructured interview and several self-rating questionnaires in their households. Taking the high comorbidity of persons with BPD into account, we compared the BPD group with four control groups with different axis 1 or personality disorders and one nonclinical group. Persons with BPD showed high comorbidity with affective, anxiety, and alcohol use disorders. With respect to suicidality, 75% reported that they wish to be dead at least sometimes, and about one-third said that they had already attempted suicide. Regarding temperament and character dimensions, our analyses revealed higher novelty seeking for persons with BPD compared to participants without BPD, although this difference was primarily attributable to males with BPD. Additionally, participants with BPD reported higher harm avoidance compared to control groups, while this was more distinctive for females. Finally, we found that persons with BPD had very low levels of self-directedness. This effect was independent from gender and was found in all group comparisons. Therapy of BPD should take into account high comorbidity and suicidality of patients. Moreover, our results show that low self-directedness seems to be specific for persons with BPD. Therefore, therapy must address those deficits by focusing on skills training as well as on aspects of maturation.
高共病率、自杀观念、难养型气质和性格是边缘型人格障碍（BPD）患者的关键症状。我们对478人进行了调查，其中40人根据SCID-II自评患有BPD。参与者在家中接受了半结构化访谈和几份自评问卷的测试。考虑到BPD患者的高共病率，我们将BPD组与四个患有不同轴I或人格障碍的对照组以及一个非临床组进行了比较。BPD患者与情感障碍、焦虑障碍和酒精使用障碍的共病率较高。在自杀倾向方面，75%的人报告称他们至少有时希望死去，约三分之一的人表示他们已经尝试过自杀。在气质和性格维度方面，我们的分析显示，与没有BPD的参与者相比，BPD患者的新奇寻求得分更高，尽管这种差异主要归因于患有BPD的男性。此外，与对照组相比，BPD患者报告的伤害回避得分更高，而这种情况在女性中更为明显。最后，我们发现BPD患者的自我导向水平非常低。这种影响与性别无关，在所有组间比较中均有发现。BPD的治疗应考虑患者的高共病率和自杀倾向。此外，我们的结果表明，低自我导向似乎是BPD患者所特有的。因此，治疗必须通过专注于技能培训以及成熟方面来解决这些缺陷。
