Nysæter Tor E, Nordahl Hans M
Department of Psychiatry, Sørlandet Hospital HF, Arendal, Norway.
Nord J Psychiatry. 2012 Jun;66(3):209-14. doi: 10.3109/08039488.2011.621976. Epub 2011 Oct 24.
The rates of remission of comorbid personality disorders for patients with a primary borderline personality disorder (BPD) have previously only been addressed in samples of inpatients or former inpatients with BPD receiving treatment-as-usual.
The aim of the current study was to assess the rates of remission of comorbid axis II personality disorders in a sample of 32 outpatients with a primary BPD receiving open-ended non-manualized psychotherapy.
Structured psychiatric interviews for DSM-IV were conducted by independent assessors at intake, discharge and 2-year follow-up. Independent t-test, chi-square and McNemar analyses based on intent-to-treat were used.
The overall rate of comorbid axis II disorders was significantly reduced from intake to 2-year follow-up. Patients with non-remitted BPD had significantly more PD diagnoses and symptomatic distress on all outcome measures at follow-up.
Comorbid personality disorders among outpatients with BPD can be expected to remit with time and with remission of BPD. In the current sample of outpatients, comorbid paranoid, avoidant and obsessive-compulsive personality disorders at 2-year follow-up were associated with non-remitted BPD. The clinical implication of the results is that especially comorbid avoidant and obsessive-compulsive personality disorders may require specific attention in treatment of patients with BPD.
先前仅在接受常规治疗的住院或曾经住院的原发性边缘型人格障碍（BPD）患者样本中探讨过共病性人格障碍的缓解率。
本研究旨在评估32例接受开放式非标准化心理治疗的原发性BPD门诊患者样本中共病的轴II人格障碍的缓解率。
由独立评估者在入组、出院时及2年随访时进行DSM-IV结构化精神科访谈。采用基于意向性治疗的独立t检验、卡方检验和McNemar分析。
从入组到2年随访，共病的轴II障碍总体发生率显著降低。未缓解的BPD患者在随访时所有结局指标上的人格障碍诊断和症状困扰显著更多。
预计BPD门诊患者的共病性人格障碍会随时间推移以及BPD的缓解而缓解。在当前门诊患者样本中，2年随访时共病的偏执型、回避型和强迫型人格障碍与未缓解的BPD相关。结果的临床意义在于，在BPD患者的治疗中，尤其是共病的回避型和强迫型人格障碍可能需要特别关注。
