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美国人群中与完全和部分创伤后应激障碍相关的人格障碍:来自全国酒精相关情况和条件的流行病学调查第二波的结果。

Personality disorders associated with full and partial posttraumatic stress disorder in the U.S. population: results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.

机构信息

National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.

出版信息

J Psychiatr Res. 2011 May;45(5):678-86. doi: 10.1016/j.jpsychires.2010.09.013. Epub 2010 Oct 15.

Abstract

BACKGROUND

While it is well known that personality disorders are associated with trauma exposure and PTSD, limited nationally representative data are available on DSM-IV personality disorders that co-occur with posttraumatic stress disorder (PTSD) and partial PTSD.

METHODS

Face-to-face interviews were conducted with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression analyses controlling for sociodemographics and additional psychiatric comorbidity evaluated associations of PTSD and partial PTSD with personality disorders.

RESULTS

Prevalence rates of lifetime PTSD and partial PTSD were 6.4% and 6.6%, respectively. After adjustment for sociodemographic characteristics and additional psychiatric comorbidity, respondents with full PTSD were more likely than trauma controls to meet criteria for schizotypal, narcissistic, and borderline personality disorders (ORs = 2.1-2.5); and respondents with partial PTSD were more likely than trauma controls to meet diagnostic criteria for borderline (OR = 2.0), schizotypal (OR = 1.8), and narcissistic (OR = 1.6) PDs. Women with PTSD were more likely than controls to have obsessive-compulsive PD. Women with partial PTSD were more likely than controls to have antisocial PD; and men with partial PTSD were less likely than women with partial PTSD to have avoidant PD.

CONCLUSIONS

PTSD and partial PTSD are associated with borderline, schizotypal, and narcissistic personality disorders. Modestly higher rates of obsessive-compulsive PD were observed among women with full PTSD, and of antisocial PD among women with partial PTSD.

摘要

背景

虽然众所周知,人格障碍与创伤暴露和创伤后应激障碍(PTSD)有关,但关于同时患有创伤后应激障碍(PTSD)和部分 PTSD 的 DSM-IV 人格障碍的全国代表性数据有限。

方法

对 34653 名参与第 2 波全国酒精和相关条件流行病学调查的成年人进行了面对面访谈。使用逻辑回归分析,控制社会人口统计学和其他精神共病因素,评估 PTSD 和部分 PTSD 与人格障碍的关联。

结果

终生 PTSD 和部分 PTSD 的患病率分别为 6.4%和 6.6%。在调整社会人口统计学特征和其他精神共病后,完全 PTSD 患者比创伤对照组更有可能符合精神分裂型、自恋型和边缘型人格障碍的标准(OR=2.1-2.5);部分 PTSD 患者比创伤对照组更有可能符合边缘型(OR=2.0)、精神分裂型(OR=1.8)和自恋型(OR=1.6)人格障碍的诊断标准。患有 PTSD 的女性比对照组更有可能患有强迫症人格障碍。患有部分 PTSD 的女性比对照组更有可能患有反社会人格障碍;而患有部分 PTSD 的男性比患有部分 PTSD 的女性更不可能患有回避型人格障碍。

结论

PTSD 和部分 PTSD 与边缘型、精神分裂型和自恋型人格障碍有关。在患有完全 PTSD 的女性中,强迫症人格障碍的发生率略高,而在患有部分 PTSD 的女性中,反社会人格障碍的发生率略高。

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