Jansson Irene, Hesse Morten, Fridell Mats
Department of Psychology, Lund University, Lund, Denmark.
Am J Addict. 2008 May-Jun;17(3):172-5. doi: 10.1080/10550490802019725.
Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms.
人格障碍与多个领域的功能障碍相关。近期的纵向研究表明,人格障碍还能预测日后生活中出现的问题,以及对抑郁症和焦虑症治疗的不良反应。本研究评估了在瑞典接受药物滥用治疗的一组女性中,人格障碍特征是否与精神症状相关。使用《精神疾病诊断与统计手册》第四版(DSM-IV)结构化临床访谈(SCID-II)人格问卷和SCID-II访谈对患者进行人格障碍诊断,然后在治疗期间及治疗后五年,让患者填写一份旨在测量精神疾病症状的自评问卷——症状自评量表90(SCL-90)。同时,除表演型人格障碍外,所有其他人格障碍的特征均与SCL-90评分相关。在五年随访时,除偏执型和分裂样人格障碍外,大多数人格障碍仍与SCL-90评分相关。在控制SCL-90的基线评分后,品行障碍、边缘型人格障碍和自恋型人格障碍在随访时仍与症状显著相关。在控制禁欲和基线评分后,随访时只有边缘型人格障碍特征仍与SCL-90评分相关。人格障碍患者在治疗后应监测精神症状。