Laptook Rebecca S, Klein Daniel N, Dougherty Lea R
Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, USA.
Am J Psychiatry. 2006 May;163(5):865-71. doi: 10.1176/ajp.2006.163.5.865.
The purpose of this study was to examine the long-term stability of depressive personality disorder.
The subjects included 142 outpatients with axis I depressive disorders at study entry; 73 had depressive personality disorder. The patients were assessed by using semistructured diagnostic interviews at baseline and in four follow-up evaluations at 2.5-year intervals over 10.0 years. Follow-up data were available for 127 (89.4%) of the patients.
The 10.0-year stability of the diagnoses of depressive personality disorder was fair, and the rate of depressive personality disorder declined over time. The dimensional score was moderately stable over 10.0 years. Growth curve analyses revealed a sharp decline in the level of depressive personality disorder traits between the baseline and 2.5-year assessments, followed by a gradual linear decrease. Reductions in depressive personality disorder traits were associated with remission of the axis I depressive disorders. Finally, depressive personality disorder at baseline predicted the trajectory of depressive symptoms over time in patients with dysthymic disorder.
Depressive personality disorder is moderately stable, particularly when assessed with a dimensional approach. However, the diagnosis rate and traits of depressive personality disorder tend to decline over time. The degree of stability for depressive personality disorder is comparable to that for the axis II disorders in the main text of DSM-IV. Finally, depressive personality disorder has prognostic implications for the course of axis I mood disorders, such as dysthymic disorder.
本研究旨在探讨抑郁性人格障碍的长期稳定性。
研究对象包括142名研究开始时患有I轴抑郁障碍的门诊患者；其中73人患有抑郁性人格障碍。患者在基线时以及在10.0年中每2.5年进行一次的四次随访评估中，通过半结构化诊断访谈进行评估。127名（89.4%）患者有随访数据。
抑郁性人格障碍诊断的10.0年稳定性尚可，且抑郁性人格障碍的发生率随时间下降。维度得分在10.0年中具有中度稳定性。生长曲线分析显示，在基线和2.5年评估之间，抑郁性人格障碍特质水平急剧下降，随后呈逐渐线性下降。抑郁性人格障碍特质的减少与I轴抑郁障碍的缓解相关。最后，基线时的抑郁性人格障碍可预测恶劣心境障碍患者抑郁症状随时间的轨迹。
抑郁性人格障碍具有中度稳定性，尤其是采用维度评估方法时。然而，抑郁性人格障碍的诊断率和特质往往随时间下降。抑郁性人格障碍的稳定程度与《精神疾病诊断与统计手册》第四版正文里的II轴障碍相当。最后，抑郁性人格障碍对I轴心境障碍如恶劣心境障碍的病程具有预后意义。
