Department of Neuroscience, Bambino Gesù Children’s Hospital, Rome, Italy.
Psychosom Med. 2011 Nov-Dec;73(9):769-74. doi: 10.1097/PSY.0b013e318235b9b5. Epub 2011 Oct 31.
To evaluate personality disorder (PD) comorbidity and its clinical correlates in a sample of adolescents with anorexia nervosa (AN) and to compare them with similar studies on adults.
One hundred one female AN outpatients (16-18 years old)-57 with AN restrictive type and 44 with AN binge-purging type-and 71 age-matched, healthy, female participants were assessed using the Structured Clinical Interview for DSM-IV Axis II Disorders. Five selected clinical variables of AN severity were also assessed.
Overall, 24.8% of AN outpatients had one or more PD compared with 4.2% of the control participants (p < .001). PDs most frequently found in AN outpatients were avoidant, borderline, and obsessive-compulsive. Associations were found between AN binge-purging type and borderline PD and between AN restrictive type and obsessive-compulsive PD. AN outpatients with a PD had an earlier age of onset of AN (mean [standard deviation {SD}] = 15.4 [1.2] versus 16.1 [0.9], p = .002), lower lifetime lowest BMI (mean [SD] = 14.8 [1.5] versus 15.6 [1.3], p = .01), and more hospital admissions for AN (mean [SD] = 1.4 [0.9] versus 0.3 [0.6], p < .001) compared with those without PDs.
Associations were found between AN and PDs in adolescents similar to those found in adults. The presence of a PD is associated with a greater severity of AN. PD assessment of adolescent AN patients may permit a more accurate diagnosis and better treatment planning.
评估厌食症（AN）青少年样本中的人格障碍（PD）共病及其临床相关性，并将其与成人的类似研究进行比较。
101 名女性 AN 门诊患者（16-18 岁）-57 名 AN 限制型和 44 名 AN 暴食-清肠型-和 71 名年龄匹配的健康女性参与者，使用 DSM-IV 轴 II 障碍的结构临床访谈进行评估。还评估了 AN 严重程度的五个选定临床变量。
总体而言，24.8%的 AN 门诊患者存在一种或多种 PD，而对照组参与者为 4.2%（p<.001）。在 AN 门诊患者中最常发现的 PD 是回避型、边缘型和强迫型。在 AN 暴食-清肠型和边缘型 PD 之间，以及在 AN 限制型和强迫型 PD 之间发现了关联。患有 PD 的 AN 门诊患者 AN 的发病年龄更早（平均值[标准差]为 15.4[1.2]与 16.1[0.9]，p=.002），终生最低 BMI 更低（平均值[标准差]为 14.8[1.5]与 15.6[1.3]，p=.01），AN 住院次数更多（平均值[标准差]为 1.4[0.9]与 0.3[0.6]，p<.001）。
青少年 AN 与 PD 之间的关联与成人相似。PD 的存在与 AN 的严重程度更高相关。对青少年 AN 患者进行 PD 评估可能会进行更准确的诊断和更好的治疗计划。
