Ansell Emily B, Sanislow Charles A, McGlashan Thomas H, Grilo Carlos M
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
Compr Psychiatry. 2007 Jul-Aug;48(4):329-36. doi: 10.1016/j.comppsych.2007.02.001. Epub 2007 Apr 6.
This study compared psychosocial functioning and treatment utilization in 130 participants who were diagnosed with a borderline personality disorder (BPD), a non-BPD personality disorder (OPD), a mood and/or anxiety disorder (MAD), or had no current psychiatric diagnosis and served as a healthy comparison group. Diagnostic and Statistical Manual of Mental Disorders (4th Edition) diagnoses, psychosocial functioning, and treatment utilization were determined by using well-established semistructured research interviews conducted by trained doctoral-level clinicians. Analysis of variance revealed the most severe deficits in functioning characterized the BPD group across areas of global functioning with more moderate impairments in functioning occurring in OPD and MAD groups. The BPD group was characterized by significantly greater psychiatric and nonpsychiatric treatment utilization than the other groups. These findings indicate that BPD as well as other personality disorders are a source of considerable psychologic distress and functional impairment equivalent to, and at times exceeding, the distress found in mood and anxiety disorders. The public health impact of BPD diagnosis is highlighted by the high rates of psychiatric and nonpsychiatric treatment utilization.
本研究比较了130名参与者的心理社会功能和治疗利用情况,这些参与者被诊断为边缘性人格障碍(BPD)、非BPD人格障碍(OPD)、情绪和/或焦虑障碍(MAD),或目前没有精神疾病诊断,作为健康对照组。《精神疾病诊断与统计手册》(第4版)的诊断、心理社会功能和治疗利用情况是通过由训练有素的博士级临床医生进行的成熟的半结构化研究访谈来确定的。方差分析显示,功能最严重的缺陷表现在BPD组的整体功能领域,OPD组和MAD组的功能损害较为中度。BPD组的特点是精神科和非精神科治疗利用率明显高于其他组。这些发现表明,BPD以及其他人格障碍是相当大的心理困扰和功能损害的来源,等同于甚至有时超过情绪和焦虑障碍中的困扰。BPD诊断的公共卫生影响通过精神科和非精神科治疗的高利用率得到凸显。