Asnaani Anu, Chelminski Iwona, Young Diane, Zimmerman Mark
Department of Psychiatry and Human Behaviour, Brown University School of Medicine, Rhode Island Hospital, Providence, RI, USA.
J Pers Disord. 2007 Dec;21(6):615-25. doi: 10.1521/pedi.2007.21.6.615.
Many studies have compared the demographic and clinical characteristics of patients with and without borderline personality disorder (BPD), but there is limited knowledge on differences within the population of borderline patients. One potential index of heterogeneity is disorder severity. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined whether the severity of borderline personality disorder, as measured by the number of criteria present, is associated with co-morbidity of Axis I and Axis II diagnoses, as well as demographic factors and psychosocial functioning. Two thousand three hundred psychiatric outpatients were interviewed with the Structured Interview for DSM-IV Personality (SIDP-IV). Approximately ten percent (n = 237) of the patients were diagnosed with BPD, and they were divided into four groups based on the number of DSM-IV criteria met, 5 (n = 89), 6 (n = 70), 7 (n = 46), and 8 or 9 (n = 32). There were greater rates of drug use disorders and comorbid Axis II disorders, as well as a greater number of suicidal gestures, in patients meeting seven or more BPD criteria. There were no significant differences between the groups in the number and specific rates of other co-morbid Axis I disorders, other measures of psychosocial functioning, or demographic correlates. Sub-typing of borderline patients by the number of criteria met provides a limited explanation for heterogeneity within BPD patients.
许多研究比较了有无边缘型人格障碍(BPD)患者的人口统计学和临床特征,但对于边缘型患者群体内部的差异了解有限。异质性的一个潜在指标是疾病严重程度。在罗德岛改善诊断评估和服务方法(MIDAS)项目的本报告中,我们研究了以存在的标准数量衡量的边缘型人格障碍严重程度是否与轴I和轴II诊断的共病、人口统计学因素以及心理社会功能相关。对2300名精神科门诊患者进行了DSM-IV人格结构化访谈(SIDP-IV)。约10%(n = 237)的患者被诊断为BPD,他们根据满足的DSM-IV标准数量分为四组,5条(n = 89)、6条(n = 70)、7条(n = 46)以及8条或9条(n = 32)。满足七条或更多BPD标准的患者中,药物使用障碍和共病轴II障碍的发生率更高,自杀姿态的数量也更多。在其他共病轴I障碍的数量和特定发生率、心理社会功能的其他测量指标或人口统计学相关性方面,各组之间没有显著差异。根据满足的标准数量对边缘型患者进行亚型划分,对BPD患者内部的异质性提供了有限的解释。