Tyrer Peter, Coombs Natalie, Ibrahimi Fatema, Mathilakath Anand, Bajaj Priya, Ranger Maja, Rao Bharti, Din Raana
Department of Psychological Medicine, Imperial College, Charing Cross Campus, St Dunstan's Road, London W6 8RP, UK.
Br J Psychiatry Suppl. 2007 May;49:s51-9. doi: 10.1192/bjp.190.5.s51.
The assessment of personality disorder is currently inaccurate, largely unreliable, frequently wrong and in need of improvement.
To describe the errors inherent in the current systems and to indicate recent ways of improving personality assessment.
Historical review, description of recent developments, including temporal stability, and of studies using document-derived assessment.
Studies of interrater agreement and accuracy of diagnosis in complex patients with independently established personality status using document-derived assessment (PAS-DOC) with a four personality cluster classification, showed very good agreement between raters for the flamboyant cluster B group of personalities, generally good agreement for the anxious/dependent cluster C group and inhibited (obsessional) cluster D group, but only fair agreement for the withdrawn cluster A group. Overall diagnostic accuracy was 71%.
Personality function or diathesis, a fluctuating state, is a better description than personality disorder. The best form of assessment is one that uses longitudinal repeated measures using a four-dimensional system.
目前对人格障碍的评估不准确，在很大程度上不可靠，常常出错且需要改进。
描述当前系统中固有的错误，并指出近期改进人格评估的方法。
历史回顾，描述近期进展，包括时间稳定性，以及使用文件衍生评估的研究。
对具有独立确定人格状态的复杂患者使用文件衍生评估（PAS-DOC）进行四分型人格分类的评分者间一致性和诊断准确性研究表明，评分者对浮夸的B型人格组的一致性非常好，对焦虑/依赖的C型人格组和抑制型（强迫型）D型人格组的一致性总体良好，但对退缩的A型人格组的一致性仅为一般。总体诊断准确性为71%。
人格功能或素质是一种波动状态，比人格障碍更能准确描述。最佳评估形式是使用四维系统进行纵向重复测量。
