Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Psychiatry. 2012 Summer;75(2):120-34. doi: 10.1521/psyc.2012.75.2.120.
The aims of this study were to examine the prevalence of personality disorders (PD) in patients with schizophrenia spectrum disorders (SSD), to examine the interaction of axis-I and axis-II symptoms to provide an estimate on the confounding potential of SSD psychopathology in the establishment of DSM-IV PD diagnoses, and to discuss implications concerning the proposed changes in DSM-5. Patients with SSD, aged 18 to 65 years, and being at least partially remitted (PANSS total score < 75) were included. PD was examined categorically and dimensionally using the SCID-II screening questionnaire and interview, and SSD psychopathology was rated using the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). Forty-five patients (31 with schizophrenia) were included in the current study. Mean age was 37.2 years, and the median duration of illness was 9.5 years. Mean PANSS total score was 42.5. The cumulative prevalence of PD in our collective was 20%, with obsessive-compulsive, antisocial, and borderline PD being the most frequent. There were no cases of cluster A PD diagnoses. In the dimensional analysis, numerous correlations of small to medium effect size emerged between maladaptive personality traits and SSD psychopathology. PD is present in a clinically relevant subgroup of SSD patients and has to be recognized in SSD treatment. Currently, it remains unclear to what extent correlations between personality traits and SSD symptoms can be explained by content overlap or co-variation of SSD psychopathology and PD traits. SSD psychopathology may bias PD diagnostics and lead to a higher percentage of categorical PD diagnoses, especially considering the proposed changes in DSM-5.
本研究旨在考察精神分裂症谱系障碍（SSD）患者中人格障碍（PD）的患病率，考察轴 I 和轴 II 症状的相互作用，以评估 SSD 精神病理学在DSM-IV PD 诊断中的混杂潜在影响，并讨论与 DSM-5 中提出的变化有关的影响。研究对象为年龄在 18 至 65 岁之间、至少部分缓解（PANSS 总分<75）的 SSD 患者。使用 SCID-II 筛查问卷和访谈对 PD 进行分类和维度评估，使用阳性和阴性综合征量表评估 SSD 精神病理学（PANSS）。本研究共纳入 45 例患者（31 例为精神分裂症）。平均年龄为 37.2 岁，平均病程为 9.5 年。平均 PANSS 总分为 42.5。我们的研究中 PD 的累积患病率为 20%，其中强迫型、反社会型和边缘型 PD 最为常见。没有 A 型 PD 诊断。在维度分析中，在适应不良的人格特征和 SSD 精神病理学之间出现了许多小到中等效应大小的相关性。PD 存在于 SSD 患者的一个具有临床意义的亚组中，在 SSD 治疗中必须认识到这一点。目前，人格特征与 SSD 症状之间的相关性在多大程度上可以归因于 SSD 精神病理学和 PD 特征的内容重叠或共同变化尚不清楚。SSD 精神病理学可能会影响 PD 的诊断，导致更大概率出现分类 PD 诊断，尤其是考虑到 DSM-5 中提出的变化。
