Grilo Carlos M, Sanislow Charles A, Shea M Tracie, Skodol Andrew E, Stout Robert L, Gunderson John G, Yen Shirley, Bender Donna S, Pagano Maria E, Zanarini Mary C, Morey Leslie C, McGlashan Thomas H
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
J Consult Clin Psychol. 2005 Feb;73(1):78-85. doi: 10.1037/0022-006X.73.1.78.
In this study, the authors examined prospectively the 24-month natural course of remission from major depressive disorder (MDD) as a function of personality disorder (PD) comorbidity. In 302 participants (196 women, 106 men), psychiatric and PDs were assessed at baseline with diagnostic interviews, and the course of MDD was assessed with the Longitudinal Interval Follow-Up Evaluation at 6-, 12-, and 24-month follow-ups. Survival analyses revealed an overall 24-month remission rate of 73.5% for MDD that differed little by gender. Participants with MDD who had certain forms of coexisting PD psychopathology (schizotypal, borderline, or avoidant) as their primary PD diagnoses had a significantly longer time to remission from MDD than did patients with MDD without any PD. These PDs emerged as robust predictors of slowed remission from MDD even when controlling for other negative prognostic predictors.
在本研究中,作者前瞻性地考察了重度抑郁症(MDD)缓解的24个月自然病程与人格障碍(PD)共病的关系。在302名参与者(196名女性,106名男性)中,在基线时通过诊断访谈评估精神疾病和人格障碍,并在6个月、12个月和24个月随访时通过纵向间隔随访评估来评估MDD的病程。生存分析显示,MDD的总体24个月缓解率为73.5%,性别差异不大。以某些形式的共存PD精神病理学(分裂型、边缘型或回避型)作为主要PD诊断的MDD参与者,与无任何PD的MDD患者相比,从MDD中缓解的时间显著更长。即使在控制了其他负面预后预测因素后,这些PD仍然是MDD缓解缓慢的有力预测因素。