Chen Henian, Cohen Patricia, Crawford Thomas N, Kasen Stephanie, Johnson Jeffrey G, Berenson Kathy
New York State Psychiatric Institute, New York 10032, USA.
J Pers Disord. 2006 Oct;20(5):510-23. doi: 10.1521/pedi.2006.20.5.510.
Little is known about long-term prognostic implications of personality disorder (PD) for quality of life (QOL) in the young adult population not selected for psychiatric treatment. The purpose of this study was to determine the association of PDs with QOL assessed after an 11-year interval. PDs were assessed in 1991-1994 at mean age 22, and indicators of QOL were assessed in 2001-2004 at mean age 33 based on a community sample of 588 young adults. Findings indicated that any PD, or a cluster A, B, or C PD each were independently associated with elevated impairment in overall QOL after adjusting for demographic variables, co-occurring Axis I disorder, and physical illness, and PDs in other clusters. Cluster B PD had a greatest adverse impact on QOL. Symptoms of antisocial, borderline, and schizotypal PD symptoms were independently associated with significant reductions in QOL; avoidant, paranoid, and dependent PD symptoms were associated with smaller reductions, not reaching statistical significance. Symptoms of other individual PDs were not associated with reduced QOL. PDs in young adults in the community have an enduring and adverse impact on subsequent QOL that cannot be attributed to physical illness or Axis I psychiatric disorder.
对于未接受精神科治疗的年轻成年人群，人格障碍（PD）对生活质量（QOL）的长期预后影响知之甚少。本研究的目的是确定在11年间隔后评估的人格障碍与生活质量之间的关联。1991年至1994年对平均年龄22岁的人群进行了人格障碍评估，2001年至2004年对平均年龄33岁的588名年轻成年人的社区样本进行了生活质量指标评估。研究结果表明，在调整了人口统计学变量、共病的轴I障碍、躯体疾病以及其他类别的人格障碍后，任何一种人格障碍，或A、B或C类人格障碍各自均与总体生活质量的损害增加独立相关。B类人格障碍对生活质量的负面影响最大。反社会型、边缘型和分裂型人格障碍症状与生活质量的显著降低独立相关；回避型、偏执型和依赖型人格障碍症状与较小程度的降低相关，但未达到统计学意义。其他个体人格障碍症状与生活质量降低无关。社区中年轻成年人的人格障碍对随后的生活质量有持久的负面影响，且不能归因于躯体疾病或轴I精神障碍。
