Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia.
Early Interv Psychiatry. 2012 Aug;6(3):247-55. doi: 10.1111/j.1751-7893.2012.00365.x. Epub 2012 Jun 5.
There is clinical uncertainty as to whether borderline personality disorder (BPD) traits in those with an 'at risk mental state' have an effect on the risk of 'transition' to psychosis. We aimed to investigate the relationship between baseline BPD features, risk of transition and type of psychotic disorder experienced.
This is a case-control study of 'ultra high risk' (UHR) for psychosis patients treated at the clinic, between 2004 and 2007. 'Cases' were UHR individuals who made the 'transition' to full threshold psychotic disorder within 24 months; 'control' group was a matched UHR sample who had not developed a psychotic disorder at 24 months. Individuals were matched on time of entry to the clinic, age and gender. Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) BPD features were assessed from clinical assessments using a structured instrument (Structured Clinical Interview for DSM-IV Axis II Disorder for BPD (SCID-II BPD)). Psychosis diagnosis following transition was rated from the clinical files using the operational criteria in studies of psychotic illness (OPCRIT) computer algorithm. The number of BPD traits and number with full threshold BPD were compared in those who developed psychosis and those who did not.
We analysed data from 48 cases and 48 controls. There was no statistically significant difference in the rate of transition to psychosis for those with baseline full-threshold BPD, compared with those without BPD. The number of BPD traits or number with full threshold BPD did not differ by psychosis diagnosis grouping.
Co-occurring BPD or BPD features does not appear to strongly influence the risk of short-term transition to psychosis or the risk of developing a non-affective psychotic disorder in this population.
对于处于“风险精神状态”的个体，边缘型人格障碍（BPD）特征是否会影响向精神病的“转变”，临床上存在不确定性。我们旨在研究基线 BPD 特征与“转变”风险和所经历的精神病类型之间的关系。
这是一项针对诊所中处于精神病超高风险（UHR）状态的患者的病例对照研究，研究时间为 2004 年至 2007 年。“病例”为在 24 个月内转变为全阈值精神病的 UHR 个体；“对照组”为在 24 个月内未发展为精神病的匹配 UHR 样本。个体根据进入诊所的时间、年龄和性别进行匹配。使用结构化工具（DSM-IV 轴 II 障碍的结构化临床访谈用于 BPD（SCID-II BPD））从临床评估中评估精神障碍诊断与统计手册，第四版（DSM-IV）BPD 特征。使用精神病研究中的操作性标准（OPCRIT）计算机算法从临床档案中对“转变”后发生的精神病诊断进行评分。比较了发展为精神病和未发展为精神病的个体中 BPD 特征的数量和全阈值 BPD 的数量。
我们分析了 48 例病例和 48 例对照的数据。与没有 BPD 的个体相比，基线全阈值 BPD 的个体发生精神病的转化率没有统计学意义上的显著差异。BPD 特征的数量或全阈值 BPD 的数量在精神病诊断分组中没有差异。
在该人群中，共同发生的 BPD 或 BPD 特征似乎不会强烈影响短期向精神病转变的风险或发展非情感性精神病的风险。
