Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, NY 11530, USA.
J Pers Disord. 2011 Apr;25(2):235-47. doi: 10.1521/pedi.2011.25.2.235.
The DSM-5 Personality and Personality Disorders Workgroup proposed that five DSM-IV personality disorders be eliminated as formal diagnostic categories (paranoid, schizoid, histrionic, narcissistic, and dependent), because these syndromes purportedly have low clinical utility and minimal evidence for validity. Scrutiny of studies cited in support of this proposal reveals difficulties in three areas: (1) Inadequate information regarding parameters of the literature search; (2) Mixed empirical support for proposed changes; and (3) Selective attention to certain disorders and not others. Review of validity and clinical utility data related to dependent personality disorder indicates that evidence regarding this syndrome does not differ from that of syndromes proposed for retention in DSM-5. Limitations in the research base cited by the workgroup illuminates gaps in the personality disorder literature, and may serve as a starting point for systematic research on personality pathology so that adequate empirical data are available to decide which syndromes to retain, revise, or remove in future versions of the diagnostic manual.
DSM-5 人格与人格障碍工作小组提议将五种类别（偏执型、分裂样型、表演型、自恋型和依赖型）的人格障碍从正式诊断类别中删除，因为这些综合征据称临床实用性低，有效性的证据也很少。对支持这一提议的研究进行审查，揭示了在三个方面存在困难：（1）文献检索参数的信息不足；（2）对拟议变更的实证支持不一致；（3）对某些障碍而不是其他障碍的选择性关注。对与依赖型人格障碍相关的效度和临床实用性数据的审查表明，关于该综合征的证据与保留在 DSM-5 中的综合征的证据没有区别。工作小组引用的研究基础的局限性凸显了人格障碍文献中的空白，这可能成为人格病理学系统研究的起点，以便为保留、修订或删除诊断手册中的哪些综合征提供足够的实证数据。
