Sack M, Sachsse U, Overkamp B, Dulz B
Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar, Technische Universität München, Langerstrasse 3, Munich, Germany.
Nervenarzt. 2013 May;84(5):608-14. doi: 10.1007/s00115-012-3489-6.
There is current controversy about the diagnostic overlap between personality disorders and trauma-related disorders.
Applying a multicenter study design, trauma-related disorders were investigated via interview assessment in 136 patients with borderline personality disorder (BPD) in 5 specialized treatment centers. Additionally a spectrum of psychological symptoms and prevalence of lifetime traumatic experiences were assessed by questionnaire measures.
Diagnostic overlap between BPD and PTSD was found to be high (79%) as well as the overlap of BPD with complex PTSD (55%) and severe dissociative disorders (41%). Including neglect and emotional violence as trauma categories, an extremely high prevalence of lifetime traumatic experiences was reported (96%). Experiences of sexual violence were reported by 48% of all female and 28% of all male patients. Severe forms of physical violence were reported by 65% of all patients.
BPD patients with severe psychopathology show a high comorbidity with trauma-related disorders including dissociative disorders. This association has to be taken into account when planning psychological treatment.
目前关于人格障碍与创伤相关障碍之间的诊断重叠存在争议。
采用多中心研究设计,在5个专业治疗中心对136例边缘型人格障碍(BPD)患者进行访谈评估,以调查创伤相关障碍。此外,通过问卷调查评估一系列心理症状和终身创伤经历的患病率。
发现BPD与创伤后应激障碍(PTSD)之间的诊断重叠率很高(79%),BPD与复杂性PTSD(55%)和严重解离障碍(41%)之间的重叠率也很高。将忽视和情感暴力纳入创伤类别后,报告的终身创伤经历患病率极高(96%)。所有女性患者中有48%、所有男性患者中有28%报告有性暴力经历。65%的患者报告有严重形式的身体暴力。
患有严重精神病理学的BPD患者与包括解离障碍在内的创伤相关障碍共病率很高。在规划心理治疗时必须考虑到这种关联。