边缘型人格障碍患者与轴 II 对照受试者的持续症状缓解和康复的获得和稳定性：一项 16 年的前瞻性随访研究。
Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study.
机构信息
McLean Hospital, Belmont, MA, USA. zanarini@mc lean.harvard.edu
出版信息
Am J Psychiatry. 2012 May;169(5):476-83. doi: 10.1176/appi.ajp.2011.11101550.
OBJECTIVE
The purposes of this study were to determine time to attainment of symptom remission and to recovery lasting 2, 4, 6, or 8 years among patients with borderline personality disorder and comparison subjects with other personality disorders and to determine the stability of these outcomes.
METHOD
A total of 290 inpatients with borderline personality disorder and 72 comparison subjects with other axis II disorders were assessed during their index admission using a series of semistructured interviews, which were administered again at eight successive 2-year follow-up sessions. For inclusion in the study, patients with borderline personality disorder had to meet criteria for both the Revised Diagnostic Interview for Borderlines and DSM-III-R.
RESULTS
Borderline patients were significantly slower to achieve remission or recovery (which involved good social and vocational functioning as well as symptomatic remission) than axis II comparison subjects. However, by the time of the 16-year follow-up assessment, both groups had achieved similarly high rates of remission (range for borderline patients: 78%-99%; range for axis II comparison subjects: 97%-99%) but not recovery (40%-60% compared with 75%-85%). In contrast, symptomatic recurrence and loss of recovery occurred more rapidly and at substantially higher rates among borderline patients than axis II comparison subjects (recurrence: 10%-36% compared with 4%-7%; loss of recovery: 20%-44% compared with 9%-28%).
CONCLUSIONS
Our results suggest that sustained symptomatic remission is substantially more common than sustained recovery from borderline personality disorder and that sustained remissions and recoveries are substantially more difficult for individuals with borderline personality disorder to attain and maintain than for individuals with other forms of personality disorder.
目的
本研究旨在确定边缘型人格障碍患者达到症状缓解以及缓解持续 2、4、6 或 8 年的时间，以及与其他人格障碍患者的比较，并确定这些结果的稳定性。
方法
共有 290 名边缘型人格障碍住院患者和 72 名其他轴 II 障碍的比较患者在他们的指数入院期间使用一系列半结构化访谈进行评估，并在随后的 8 个连续 2 年随访期间再次进行评估。为了纳入研究，边缘型人格障碍患者必须符合修订后的边缘型诊断访谈和 DSM-III-R 的标准。
结果
边缘型患者达到缓解或恢复（涉及良好的社会和职业功能以及症状缓解）的速度明显慢于轴 II 比较患者。然而，到 16 年随访评估时，两组都达到了相似的高缓解率（边缘型患者的范围：78%-99%；轴 II 比较患者的范围：97%-99%），但没有恢复（40%-60% 与 75%-85%）。相比之下，边缘型患者比轴 II 比较患者更快且更高的比例出现症状复发和恢复丧失（复发：10%-36%与 4%-7%；恢复丧失：20%-44%与 9%-28%）。
结论
我们的结果表明，持续的症状缓解比从边缘型人格障碍中持续恢复更为常见，对于边缘型人格障碍患者来说，持续缓解和恢复的难度远远大于其他形式的人格障碍患者。
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