Rosenbluth Michael, Macqueen Glenda, McIntyre Roger S, Beaulieu Serge, Schaffer Ayal
Toronto East General Hospital Day, Treatment Program, East York, Ontario, Canada.
Ann Clin Psychiatry. 2012 Feb;24(1):56-68.
The association between mood disorders and personality disorders (PDs) is complicated clinically, conceptually, and neurobiologically. There is a need for recommendations to assist clinicians in treating these frequently encountered patients.
The literature was reviewed with the purpose of identifying clinically relevant themes. MedLine searches were supplemented with manual review of the references in relevant papers. From the extant evidence, consensus-based recommendations for clinical practice were developed.
Key issues were identified with regards to the overlap of PDs and mood disorders, including whether certain personality features predispose to mood disorders, whether PDs can reliably be recognized if there is an Axis I disorder present, whether personality disturbances arise as a consequence or are a forme fruste of mood disorders, and whether personality traits or disorders modify treatment responsiveness and outcome of mood disorders.
This paper describes consensus-based clinical recommendations that arise from a consideration of how signals from the literature can impact clinical practice in the treatment of patients with comorbid mood and personality pathology. Additional treatment studies of patients with the comorbid conditions are required to further inform clinical practice.
情绪障碍与人格障碍（PDs）之间的关联在临床、概念和神经生物学方面都很复杂。需要提出相关建议以帮助临床医生治疗这些常见患者。
对文献进行综述以确定临床相关主题。通过检索医学文献数据库（MedLine），并人工查阅相关论文的参考文献进行补充。基于现有证据，制定了基于共识的临床实践建议。
确定了与人格障碍和情绪障碍重叠相关的关键问题，包括某些人格特征是否易引发情绪障碍、如果存在轴I障碍是否能可靠地识别出人格障碍、人格障碍是情绪障碍的后果还是其一种顿挫型表现、以及人格特质或障碍是否会改变情绪障碍的治疗反应性和结局。
本文描述了基于共识的临床建议，这些建议源于对文献中的信息如何影响共病情绪和人格病理患者治疗的临床实践的思考。需要对共病患者进行更多的治疗研究，以便为临床实践提供更多信息。
