Silverman J M, Pinkham L, Horvath T B, Coccaro E F, Klar H, Schear S, Apter S, Davidson M, Mohs R C, Siever L J
Psychiatry Service, Bronx VA Medical Center, NY 10468.
Am J Psychiatry. 1991 Oct;148(10):1378-85. doi: 10.1176/ajp.148.10.1378.
This study tested the hypothesis that the risk for affective and impulsive personality disorder traits commonly found in patients with borderline personality disorder would be greater in the first-degree relatives of probands with borderline personality disorder than in two comparison groups.
Blind family history interviews were conducted with family informants to assess the extent to which first-degree relatives of 29 probands with borderline personality disorder, 22 probands with other personality disorders who met three or fewer of the criteria for borderline personality disorder, and 43 probands with schizophrenia fulfilled operationalized criteria for the two kinds of personality disorder traits and for other diagnostic categories. The crude proportions of adult relatives with each diagnosis, as well as the age-adjusted morbid risks, were assessed in the three groups of relatives.
The risks for affective and impulsive personality disorder traits were independently greater in the 129 relatives of the borderline probands than in the 105 relatives of the probands with other personality disorders and the 218 relatives of the schizophrenic probands. There was no similarly greater risk for any other psychiatric disorder assessed, including major affective disorder. In addition, the relatives of borderline probands with current or past major depressive disorder showed a greater risk for major affective disorders than the relatives of never-depressed probands with other personality disorders but not the relatives of never-depressed borderline probands.
These results suggest familial transmission of the hallmark borderline-related personality characteristics and raise the possibility that these familial traits may be partially independent.
本研究检验了以下假设,即边缘型人格障碍患者中常见的情感和冲动型人格障碍特质风险,在先证者为边缘型人格障碍的一级亲属中,会高于两个对照组。
对家族信息提供者进行盲法家族史访谈,以评估29名边缘型人格障碍先证者、22名符合边缘型人格障碍三项或更少标准的其他人格障碍先证者以及43名精神分裂症先证者的一级亲属在多大程度上符合两种人格障碍特质及其他诊断类别的操作性标准。评估了三组亲属中各诊断的成年亲属的粗略比例以及年龄调整后的患病风险。
边缘型先证者的129名亲属中情感和冲动型人格障碍特质的风险,独立地高于其他人格障碍先证者的105名亲属以及精神分裂症先证者的218名亲属。在评估的任何其他精神障碍中,包括重度情感障碍,均不存在类似的更高风险。此外,目前或过去患有重度抑郁症的边缘型先证者的亲属,比从未患抑郁症的其他人格障碍先证者的亲属患重度情感障碍的风险更高,但比从未患抑郁症的边缘型先证者的亲属风险高。
这些结果表明与边缘型相关的标志性人格特征存在家族传递,并增加了这些家族特质可能部分独立的可能性。