Zanarini Mary C, Frankenburg Frances R, Yong Lynne, Raviola Giuseppe, Bradford Reich D, Hennen John, Hudson James I, Gunderson John G
The Laboratory for the Study for Adult Development, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, Belmont, MA 02478, USA.
J Pers Disord. 2004 Oct;18(5):439-47. doi: 10.1521/pedi.18.5.439.51327.
The purpose of this study was to assess the prevalence of each of the nine DSM criteria for borderline personality disorder and the prevalence of the disorder itself in the first-degree relatives of borderline probands and Axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial borderline psychopathology using the Revised Family History Questionnaire--a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of Axis II comparison subjects was assessed. Both DSM-III-R and DSM-IV BPD were found to be more common among the relatives of borderline than Axis II comparison probands. However, five of the criteria for BPD (inappropriate anger, affective instability, paranoia/dissociation, general impulsivity, and intense, unstable relationships) and all four sectors of borderline psychopathology (affect, cognition, impulsivity, and interpersonal relationships) were found to be both more common and discriminating than the BPD diagnosis itself. Taken together, the results of this study suggest that the subsyndromal phenomenology of BPD may be more common than the borderline diagnosis itself.
本研究的目的是评估边缘型人格障碍的九项DSM标准中每项标准的患病率,以及边缘型先证者和轴II对照受试者的一级亲属中该障碍本身的患病率。使用修订版家族史问卷(一种经证实具有可靠性的半结构化访谈)对445名住院患者进行了关于家族性边缘型精神病理学的访谈。在这445名受试者中,341名符合DIB-R和DSM-III-R的BPD标准,104名符合DSM-III-R的另一种人格障碍标准(且均不符合BPD的标准集)。对1580名边缘型先证者的一级亲属和472名轴II对照受试者的亲属的精神病理学进行了评估。发现DSM-III-R和DSM-IV的BPD在边缘型患者的亲属中比轴II对照先证者中更为常见。然而,发现BPD的五项标准(不适当的愤怒、情感不稳定、偏执/分离、一般冲动性以及强烈、不稳定的人际关系)以及边缘型精神病理学的所有四个方面(情感、认知、冲动性和人际关系)比BPD诊断本身更为常见且更具区分性。综合来看,本研究结果表明,BPD的亚综合征现象可能比边缘型诊断本身更为常见。