Department of Psychology, Washington State University, Richland, WA 99354, USA.
Clin J Pain. 2010 May;26(4):348-53. doi: 10.1097/AJP.0b013e3181cd1710.
There is considerable evidence that personality disorders, including borderline personality disorder (BPD), tend to co-occur with chronic pain. There is also evidence that mood disorders co-occur with chronic pain conditions. Given the central role of affective instability and negative mood states in BPD, we proposed that affective features of depression, anxiety, and hostility may account for the association between BPD features and the severity of pain reported in a patient sample.
Seven hundred seventy-seven patient participants completed the Battery for Health Improvement. This included measures of DSM-IV BPD features, affect scales (depression, anxiety, hostility), and pain items assessing the severity of pain and somatic symptoms.
As predicted, individuals with higher levels of BPD features reported greater severity of pain and somatic complaints, including higher levels of maximum and minimum pain levels in the past month. In addition as predicted, this association was no longer significant after controlling for affect scales. In particular, depression was strongest in accounting for this association.
These results indicate that the association between BPD features and pain is accounted for by negative affect, primarily in the form of depression. This is consistent with current theoretical perspectives on BPD. This also suggests that clinicians observing or detecting BPD features among pain patients should consider negative affect, especially depression, in addressing these issues.
有大量证据表明，人格障碍，包括边缘型人格障碍（BPD），往往与慢性疼痛同时发生。也有证据表明，情绪障碍与慢性疼痛状况同时发生。鉴于情感不稳定和负面情绪状态在 BPD 中的核心作用，我们提出抑郁、焦虑和敌意的情感特征可能解释了 BPD 特征与患者样本中报告的疼痛严重程度之间的关联。
777 名患者参与者完成了健康改善电池测试。这包括 DSM-IV BPD 特征、情感量表（抑郁、焦虑、敌意）和疼痛项目，评估疼痛和躯体症状的严重程度。
正如预期的那样，BPD 特征水平较高的个体报告了更严重的疼痛和躯体症状，包括过去一个月中最高和最低疼痛水平的更高水平。此外，正如预期的那样，在控制了情感量表后，这种关联不再显著。特别是抑郁在解释这种关联方面最强。
这些结果表明，BPD 特征与疼痛之间的关联是由负性情绪引起的，主要是以抑郁的形式。这与当前关于 BPD 的理论观点一致。这也表明，在观察或检测疼痛患者的 BPD 特征时，临床医生应考虑负性情绪，特别是抑郁，以解决这些问题。
