Department of Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
Psychiatry Res. 2013 Dec 30;210(3):986-93. doi: 10.1016/j.psychres.2013.07.028. Epub 2013 Aug 28.
The aim of this study was to investigate the presence of premorbid Personality Disorder (PD) and its relationship with clinical correlates in patients with Delusional Disorder (DD). Eighty-six outpatients with DD whose diagnoses were confirmed using the Structured Clinical Interview for DSM-IV Axis I (SCID-I) Disorders (psychosis module) were evaluated for premorbid PD utilizing the Standardized Assessment of Personality (SAP). Psychopathology was assessed using Module B of SCID-I and the Positive and Negative Syndrome Scale (PANSS); psychosocial functioning was evaluated with the Global Assessment of Functioning scale. Premorbid intelligence was assessed using the Wechsler Adult Intelligence Scale-Third Edition, vocabulary subtest. A sociodemographic-clinical questionnaire was completed. Sixty-four percent of the patients had at least one premorbid PD, the most common being paranoid PD (38.4%), followed by schizoid PD (12.8%). The presence of at least one premorbid PD was significantly associated with higher scores for psychopathology, in particular, on the affective dimension of DD symptoms. However, the presence of premorbid PD was not associated with psychosocial functioning. Each of the premorbid PD was associated with different psychopathological profiles. Premorbid PD is a relevant phenomenon in DD, given its high prevalence and comorbidity, its influence on clinical correlates and its potential ability to predict specific sub-syndromes.
本研究旨在探讨妄想障碍（DD）患者病前人格障碍（PD）的存在及其与临床特征的关系。采用DSM-IV轴 I 定式临床访谈（SCID-I）障碍（精神病模块）对 86 名经确诊为 DD 的门诊患者进行病前 PD 的评估，采用人格标准化评定（SAP）进行评估。采用 SCID-I 模块 B 和阳性与阴性综合征量表（PANSS）评估精神病理学；采用功能总体评估量表（GAF）评估心理社会功能。采用韦氏成人智力量表第三版词汇亚测验评估病前智力。完成一份社会人口学-临床问卷。64%的患者至少有一种病前 PD，最常见的是偏执型 PD（38.4%），其次是分裂样 PD（12.8%）。至少有一种病前 PD 的存在与较高的精神病理学评分显著相关，特别是在 DD 症状的情感维度上。然而，病前 PD 的存在与心理社会功能无关。每一种病前 PD 都与不同的精神病理特征相关。病前 PD 是 DD 中的一个重要现象，因为它的高患病率和共病性、对临床特征的影响以及其预测特定亚综合征的潜在能力。
