Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Psychopathology. 2011;44(1):21-6. doi: 10.1159/000317271. Epub 2010 Oct 28.
The present study investigated the relationship between psychiatric classification and personality organization (PO) in a secondary/tertiary clinical sample of chronic pain patients (CPPs).
Forty-three patients were administered the Structured Clinical Interview for DSM-IV (SCID I+II) and the Structured Interview of Personality Organization (STIPO). The prevalence of axis I and axis II disorders was correlated with the STIPO level of PO. The STIPO dimensional ratings of patients without personality disorder (PD) were compared to those of patients diagnosed with one or more PDs.
Axis I comorbidity was high (93%), and 63% of the patients met the criteria for at least one axis II diagnosis. Twenty-five patients (58%) were diagnosed as borderline PO, with high-level impairments in the dimensions 'coping/rigidity', 'primitive defenses' and 'identity'. Higher axis I and axis II comorbidity corresponded with greater severity of PO impairment. No difference was found between the dimensional ratings of patients without PD and those of patients with one or more PDs.
The assessment of PO is a crucial issue for diagnosis and treatment planning in CPPs, since it represents a measure of structural impairment that is to a considerable extent independent of axis I and II diagnoses. Moreover, the STIPO dimensional rating focuses on the most salient dysfunctions at a given time.
本研究调查了二级/三级临床慢性疼痛患者（CPP）群体中精神科分类与人格组织（PO）之间的关系。
43 名患者接受了 DSM-IV 结构临床访谈（SCID I+II）和人格组织结构访谈（STIPO）。将轴 I 和轴 II 障碍的患病率与 STIPO 的 PO 水平相关联。无人格障碍（PD）患者的 STIPO 维度评分与被诊断为一种或多种 PD 的患者进行了比较。
轴 I 共病率很高（93%），63%的患者符合至少一种轴 II 诊断标准。25 名患者（58%）被诊断为边缘型 PO，在“应对/僵化”、“原始防御”和“身份”维度上存在严重的障碍。轴 I 和轴 II 共病程度越高，PO 损害的严重程度越高。无 PD 患者的维度评分与有 1 种或多种 PD 的患者的维度评分之间无差异。
在 CPP 中，PO 的评估是诊断和治疗计划的关键问题，因为它代表了一种结构障碍的衡量标准，在很大程度上独立于轴 I 和 II 诊断。此外，STIPO 维度评分侧重于特定时间点最明显的功能障碍。
