Department of Psychology, Faculty of Health Sciences, University of Tromsø, N-9037 Tromsø, Norway; Department of Psychiatric Research, University Hospital of North Norway, Tromsø, Norway.
J Affect Disord. 2014 Jan;152-154:1-11. doi: 10.1016/j.jad.2013.08.023. Epub 2013 Sep 2.
A meta-analysis was conducted to identify the proportions of comorbid personality disorders (PD) in mood disorders.
We found 122 empirical papers published in the period 1980-2010 on participants having mood disorders in addition to a comorbid PD. Mood disorders were classified as bipolar disorders (BD), major depressive disorders (MDD) and dysthymic disorders (DYS). Several moderators were coded as well.
The risk of having at least one comorbid PD (any PD) was high across all three mood disorders (BD=.42, MDD=.45), but highest in DYS (.60). Cluster B and C PDs were most frequent in BD, while cluster C PDs dominated in MDD and DYS. Among the specific PDs, the paranoid (.11 versus .07/.05), borderline (.16 versus .14/.13), histrionic (.10 versus .06/.06) and obsessive-compulsive (.18 versus .09/.12) PDs occurred more frequently in BD versus MDD/DYS, whereas the avoidant PD (.22 versus .12/.16) was most frequent in DYS versus BD/MDD. Moderator analyses showed higher comorbidity when diagnoses were based on questionnaires versus clinical interviews, DSM-III-R versus DSM-IV, more women were included or the duration of the disorder was longer. Age of onset yielded mixed results.
Blind rating of diagnoses was recorded, but was employed in too few studies to be usable as an indication of diagnostic validity.
Personality disorders are common in mood disorders. Implications of the identified moderators as well as the new DSM-5 diagnostic system are considered.
本项荟萃分析旨在明确心境障碍共病人格障碍（PD）的比例。
我们检索了 1980 年至 2010 年间发表的共病 PD 的心境障碍患者的 122 篇实证文献。心境障碍分为双相障碍（BD）、重性抑郁障碍（MDD）和恶劣心境障碍（DYS）。同时对若干调节变量进行了编码。
所有三种心境障碍（BD=.42，MDD=.45，DYS=.60）共病至少一种 PD 的风险均较高，但以 DYS 最高。BD 中最常见的是 B 型和 C 型 PD，而 MDD 和 DYS 中以 C 型 PD 为主。在特定 PD 中，BD 中偏执型（.11 比.07/.05）、边缘型（.16 比.14/.13）、表演型（.10 比.06/.06）和强迫型（.18 比.09/.12）PD 更为常见，而回避型 PD（.22 比.12/.16）在 DYS 中最为常见，而在 BD 和 MDD 中则较少见。调节分析显示，基于问卷而非临床访谈、DSM-III-R 而非 DSM-IV、纳入更多女性或疾病持续时间更长时，共病率更高。发病年龄的结果则不一致。
虽然记录了诊断的盲法评定，但在研究中使用过少，无法作为诊断效度的指示。
人格障碍在心境障碍中很常见。考虑了已识别的调节变量以及新的 DSM-5 诊断系统的意义。
