边缘型人格障碍患者和轴 II 对照受试者报告的认知体验：一项 16 年的前瞻性随访研究。
Cognitive experiences reported by 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.
出版信息
Am J Psychiatry. 2013 Jun;170(6):671-9. doi: 10.1176/appi.ajp.2013.13010055.
OBJECTIVE
The authors assessed three main types of disturbed cognition: nonpsychotic thought (odd thinking, unusual perceptual experiences, and nondelusional paranoia), quasi-psychotic thought, and true psychotic thought in patients with borderline personality disorder followed prospectively for 16 years. They also compared the rates of these disturbed cognitions with those reported by axis II comparison subjects.
METHOD
The cognitive experiences of 362 inpatients (290 borderline patients and 72 axis II comparison subjects) were assessed at study entry using the cognitive section of the Revised Diagnostic Interview for Borderlines. Participants' cognitive experiences were reassessed every 2 years using the same interview.
RESULTS
Each of the five main types of thought studied was reported by a significantly higher percentage of patients in the borderline group than in the axis II comparison group over time. Each of these types of thought, except true psychotic thought, declined significantly over time for participants in both groups. Eleven of the 17 more specific forms of thought studied were also reported by a significantly higher percentage of patients in the borderline group over the follow-up period: magical thinking, overvalued ideas, recurrent illusions, depersonalization, derealization, undue suspiciousness, ideas of reference, other paranoid ideation, quasi-psychotic delusions, quasi-psychotic hallucinations, and true psychotic hallucinations. Fourteen specific forms of thought were found to decline significantly over time for participants in both groups: all forms of thought mentioned above except true psychotic hallucinations plus marked superstitiousness, sixth sense, telepathy, and clairvoyance.
CONCLUSIONS
Disturbed cognitions are common in patients with borderline personality disorder and are distinguishing for the disorder. They also decline substantially over time but remain a problem, particularly those of a nonpsychotic nature.
目的
作者评估了三种主要类型的认知障碍：非精神病性思维（怪异思维、异常知觉体验和非妄想性偏执）、类精神病性思维和真正的精神病性思维，对前瞻性随访 16 年的边缘型人格障碍患者进行了研究。他们还将这些认知障碍的发生率与轴 II 比较受试者的报告进行了比较。
方法
使用修订后的边缘型人格障碍诊断访谈的认知部分，在研究开始时评估了 362 名住院患者（290 名边缘型人格障碍患者和 72 名轴 II 比较受试者）的认知体验。参与者的认知体验每隔 2 年使用相同的访谈进行重新评估。
结果
随着时间的推移，研究中研究的五种主要类型的思维中的每一种，在边缘组患者中的报告比例均显著高于轴 II 比较组。对于两组参与者来说，除了真正的精神病性思维外，这些类型的思维在每个时间段都显著下降。在所研究的 17 种更具体形式的思维中，有 11 种也在随访期间被报告的比例显著高于边缘组患者：魔法思维、过高的想法、反复幻觉、人格解体、现实解体、过度怀疑、观念关联、其他偏执观念、类精神病性妄想、类精神病性幻觉和真正的精神病性幻觉。有 14 种特定形式的思维被发现随着时间的推移在两组参与者中显著下降：除了真正的精神病性幻觉之外，还包括明显的迷信、第六感、心灵感应和千里眼。
结论
认知障碍在边缘型人格障碍患者中很常见，是该障碍的特征。它们也随着时间的推移显著下降，但仍然是一个问题，特别是那些非精神病性的思维。
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