Biskin Robert S, Paris Joel, Renaud Johanne, Raz Amir, Zelkowitz Phyllis
Department of Psychiatry, McGill University, Montreal, Quebec.
J Can Acad Child Adolesc Psychiatry. 2011 Aug;20(3):168-74.
This study examined the outcomes of patients diagnosed with borderline personality disorder (BPD) prior to age 18.
In a group of 47 adolescent girls assessed over a 10 year period, 31 had a past diagnosis of BPD while 16 had not met criteria. Subjects were assessed with the SCID-I, the Diagnostic Interview for Borderlines (DIB), the SCL-90-R, the Social Adjustment Scale (SAS-SR), the Affective Lability Scale (ALS), the Barratt Impulsivity Scale (BIS), the Continuous Performance Test (CPT), the Wisconsin Card Sorting Test (WCST), and the Attention Network Task (ANT).
4.3 years after initial presentation (mean age=19.6), only 11 index patients still met criteria for BPD and no new cases developed. Those who did not remit were significantly more likely to have a current episode of major depressive disorder, lifetime substance use disorder, and self-reported childhood sexual abuse. Those who still met BPD criteria also scored higher on the ALS and the total severity scale as well as several subscales of the SCL-90, but not on other measures.
These findings support the validity of an adolescent diagnosis of BPD and show that the majority of cases that develop in early adolescence can be expected to remit within 4 years.
本研究调查了18岁之前被诊断为边缘型人格障碍（BPD）的患者的预后情况。
在一组10年间接受评估的47名青春期女孩中，31名曾被诊断为BPD，而16名未达诊断标准。对受试者进行了如下评估：SCID-I、边缘型人格障碍诊断访谈（DIB）、症状自评量表（SCL-90-R）、社会适应量表（SAS-SR）、情感不稳定性量表（ALS）、巴拉特冲动性量表（BIS）、持续性操作测验（CPT）、威斯康星卡片分类测验（WCST）以及注意网络任务（ANT）。
首次就诊4.3年后（平均年龄 = 19.6岁），只有11名指标患者仍符合BPD标准，且无新病例出现。未缓解的患者更有可能出现当前的重度抑郁症发作、终生物质使用障碍以及自我报告的童年期性虐待。仍符合BPD标准的患者在ALS和总严重程度量表以及SCL-90的几个子量表上得分也更高，但在其他测量指标上则不然。
这些发现支持青少年BPD诊断的有效性，并表明在青春期早期出现的大多数病例有望在4年内缓解。
