Kennedy S H, McVey G, Katz R
Department of Psychiatry, University of Toronto, Canada.
J Psychiatr Res. 1990;24(3):259-69. doi: 10.1016/0022-3956(90)90015-i.
Two self-report questionnaires (MCMI and BSI) designed to measure personality disorder (PD) according to DSM-III (R) criteria were administered to patients with a diagnosis of anorexia nervosa (AN) (n = 19), bulimia nervosa (BN) (n = 16), or both diagnoses (AN + BN) (n = 9), both before and after treatment for the eating disorder. The main finding was that self-reported Personality Disorder (PD) diagnoses are not stable enduring characteristics among this group of eating disorder patients. A high rate of PD diagnoses occurred in all patient groups at admission (93%) and at discharge (79%). Both MCMI and BSI scales were subject to significant change following treatment. A high prevalence of borderline personality disorder was found in patients with BN. Changes in depression and self-esteem scores correlated most strongly with changes in schizoid, schizotypal, histrionic and narcissistic scales. Assessment of PD using self-report measures should be interpreted with caution in acutely symptomatic patients with eating disorders.
两份根据《精神疾病诊断与统计手册》第三版(修订版)标准设计的用于测量人格障碍(PD)的自陈问卷(MCMI和BSI),在进食障碍治疗前后分别施用于被诊断为神经性厌食症(AN)(n = 19)、神经性贪食症(BN)(n = 16)或两种诊断皆有(AN + BN)(n = 9)的患者。主要发现是,在这组进食障碍患者中,自陈的人格障碍(PD)诊断并非稳定持久的特征。所有患者组在入院时(93%)和出院时(79%)人格障碍诊断率都很高。治疗后,MCMI和BSI量表均发生了显著变化。在神经性贪食症患者中发现边缘型人格障碍的患病率很高。抑郁和自尊分数的变化与分裂样、分裂型、表演型和自恋型量表的变化相关性最强。在有急性症状的进食障碍患者中,使用自陈测量法评估人格障碍时应谨慎解读。