Ryder Andrew G, Schuller Deborah R, Bagby R Michael
Department of Psychology, PY 153-2, Concordia University, 7141 rue Sherbrooke O., Montréal, Québec Canada, H4B 1R6.
J Affect Disord. 2006 Apr;91(2-3):217-27. doi: 10.1016/j.jad.2006.01.008. Epub 2006 Feb 17.
Depressive Personality (DP) is being evaluated for future inclusion in DSM. One recurring issue has been conceptual and empirical redundancy with Dysthymia (i.e., Dysthymic Disorder; DD).
The symptom and syndrome overlap of DP and DD were tested in a clinical sample (N = 125) using both self-report and clinician ratings.
Confirmatory factor analyses of the DP and DD symptoms indicated that models which separate these two syndromes had a better fit than a model in which all symptoms were classified together, particularly for the clinician-rated data. At the same time, the syndromes were highly correlated. Binary diagnostic analysis showed that over 80% of the individuals meeting criteria for DP also met criteria for DD. As predicted, the best fit was obtained when the 'psychological' symptoms of DD-- low self-esteem and feelings of hopelessness-- were allowed to be part of both syndromes, and 82% of patients who met criteria for both DP and DD endorsed these two symptoms.
Clinical ratings rather than structured diagnostic interviews were used. As well, some models required modification to improve fit.
Depressive personality traits can be empirically separated from DD symptoms, but including DP as a categorical diagnosis would lead to a high degree of diagnostic overlap. Much of this overlap is due to sharing psychological features in common. Revisions in the diagnostic system should find a way to incorporate depressive personality traits without insisting that they be diagnosed in a categorical manner.
抑郁性人格（DP）正在接受评估，以备将来纳入《精神疾病诊断与统计手册》（DSM）。一个反复出现的问题是它与恶劣心境（即恶劣心境障碍；DD）在概念和实证上存在冗余。
在一个临床样本（N = 125）中，使用自我报告和临床医生评定对DP和DD的症状及综合征重叠情况进行了测试。
对DP和DD症状的验证性因素分析表明，将这两种综合征区分开的模型比将所有症状归为一类的模型拟合度更好，尤其是对于临床医生评定的数据。同时，这两种综合征高度相关。二元诊断分析显示，超过80%符合DP标准的个体也符合DD标准。正如所预测的，当允许DD的“心理”症状——低自尊和绝望感——同时作为两种综合征的一部分时，得到了最佳拟合，并且82%同时符合DP和DD标准的患者认可这两种症状。
使用的是临床评定而非结构化诊断访谈。此外，一些模型需要修改以提高拟合度。
抑郁性人格特质在实证上可以与DD症状区分开来，但将DP作为一种分类诊断会导致高度的诊断重叠。这种重叠很大程度上是由于共享共同的心理特征。诊断系统的修订应该找到一种方法来纳入抑郁性人格特质，而不必坚持以分类方式对其进行诊断。
