Semke V Ia, Polozhiĭ B S, Krasik E D, Vasil'eva O A, Zalevskiĭ G V, Kornetov N A
Zh Nevropatol Psikhiatr Im S S Korsakova. 1991;91(12):7-11.
The problem of borderline conditions in the population of Siberia and the Far East is analyzed from the standpoint of a comprehensive multidisciplinary approach. The authors established the indicators, close to the real ones, of the prevalence of borderline disorders, exceeding many times the formal statistic data. Evidence is given of the role of certain personality parameters (rigidity, anxiety) and biological factors (the status of the immune and hormonal systems) in the formation and course of borderline conditions. The clinical studies carried out over time made it possible to specify definite stages in the development of borderline pathology. 3 stages were delineated: initial disorders or reactions; neurotic or neurosis-like conditions; neurotic or pathological developments of the personality. The authors demonstrate imperfection of the existing systems of psychiatric aid in respect to patients with borderline disorders and provide evidence for the necessity of organizing psychiatric services outside dispensary aid. Novel organizational models (the center for borderline conditions, the center for mental health care at industrial enterprises, municipal psychohygienic consultation) developed by the authors are provided as prognosis. These structures made it possible to enhance the efficacy of prevention and treatment of borderline conditions.
从综合多学科方法的角度分析了西伯利亚和远东地区人群中的边缘状态问题。作者确定了接近实际情况的边缘性障碍患病率指标，该指标比正式统计数据高出许多倍。文中给出了某些人格参数（僵化、焦虑）和生物学因素（免疫和激素系统状况）在边缘状态形成和发展过程中所起作用的证据。随着时间推移进行的临床研究使得明确边缘性病理发展的特定阶段成为可能。划分出了三个阶段：初始障碍或反应；神经症或类神经症状态；人格的神经症或病理发展。作者证明了现有精神科援助系统在边缘性障碍患者方面的不完善，并为在门诊援助之外组织精神科服务的必要性提供了证据。作者开发的新型组织模式（边缘状态中心、工业企业心理健康护理中心、市政心理卫生咨询）被作为预后措施提出。这些结构能够提高边缘状态的预防和治疗效果。
