Faculty of Health Sciences, Department of Psychology, University of Tromsø, Norway.
J Affect Disord. 2013 Feb 20;145(2):143-55. doi: 10.1016/j.jad.2012.07.004. Epub 2012 Sep 21.
A comprehensive meta-analysis to identify the proportions of comorbid personality disorders (PD) across the major subtypes of anxiety disorders (AD) has not previously been published.
A literature search identified 125 empirical papers from the period 1980-2010 on patients with panic disorders, social phobia, generalised anxiety, obsessive-compulsive (OCD) and post-traumatic stress disorder (PTSD). Several moderators were coded.
The rate of any comorbid PD was high across all ADs, ranging from .35 for PTSD to .52 for OCD. Cluster C PDs occurred more than twice as often as cluster A or B PDs. Within cluster C the avoidant PD occurred most frequently, followed by the obsessive-compulsive and the dependent PD. PTSD showed the most heterogeneous clinical picture and social phobia was highly comorbid with avoidant PD. A range of moderators were examined, but most were non-significant or of small effects, except an early age of onset, which in social phobia increased the risk of an avoidant PD considerably. Gender or duration of an AD was not related to variation in PD comorbidity.
Blind rating of diagnoses was recorded from the papers as an indication of diagnostic validity. However, as too few studies reported it the validity of the comorbid estimates of PD was less strong.
The findings provided support to several of the proposed changes in the forthcoming DSM-5. Further comorbidity studies are needed in view of the substantial changes in how PDs will be diagnosed in the DSM-5.
尚未有研究对主要焦虑障碍（AD）亚型中的共病人格障碍（PD）比例进行全面的荟萃分析。
文献检索确定了 1980 年至 2010 年间关于惊恐障碍、社交恐惧症、广泛性焦虑、强迫症（OCD）和创伤后应激障碍（PTSD）患者的 125 篇实证论文。对多个调节变量进行了编码。
所有 AD 中 PD 的共病率都很高，从 PTSD 的 0.35 到 OCD 的 0.52。C 群 PD 的发生率是 A 群或 B 群 PD 的两倍多。在 C 群中，回避型 PD 最常见，其次是强迫型和依赖型 PD。PTSD 表现出最具异质性的临床表现，社交恐惧症与回避型 PD 高度共病。研究了一系列调节变量，但大多数不显著或影响较小，只有发病年龄是个例外，在社交恐惧症中，发病年龄较早会大大增加患回避型 PD 的风险。AD 的性别或持续时间与 PD 共病的变化无关。
从论文中记录了诊断的盲法评估，以表明诊断的有效性。但是，由于太少的研究报告了这一点，PD 共病估计的有效性不太强。
这些发现为即将发布的 DSM-5 中的一些修改提供了支持。鉴于 PD 在 DSM-5 中的诊断方式发生了重大变化，需要进一步进行共病研究。
