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美国成年人中的人格障碍与躯体共病:来自酒精及相关状况全国流行病学调查的数据

Personality disorders and physical comorbidities in adults from the United States: data from the National Epidemiologic Survey on Alcohol and Related Conditions.

作者信息

Quirk Shae E, El-Gabalawy Renée, Brennan Sharon L, Bolton James M, Sareen Jitender, Berk Michael, Chanen Andrew M, Pasco Julie A, Williams Lana J

机构信息

IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/-Barwon Health, Ryrie Street, PO 281, Geelong, VIC, 3220, Australia,

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2015 May;50(5):807-20. doi: 10.1007/s00127-014-0974-1. Epub 2014 Oct 15.

Abstract

PURPOSE

There is a paucity of research examining the relationship between personality disorders (PDs) and chronic physical comorbidities. Consequently, we investigated associations between individual PDs and PD Clusters, and various common disease groups [cardiovascular disease (CVD), diabetes, arthritis and gastrointestinal disease (GI)] in a nationally representative survey of adults from the United States.

METHODS

This study utilized pooled data (n = 34,653; ≥20 years) from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. PDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Physical conditions were based on self-reports of being diagnosed by a health professional. Unadjusted and adjusted logistic regressions examined the relationship between PDs and physical conditions.

RESULTS

After adjustment (sociodemographic factors, past-year mood, anxiety and substance use disorders), Clusters A, B and C PDs were each associated with physical conditions (all p ≤ 0.01). Of the individual PDs, schizoid, schizotypal, narcissistic, borderline and obsessive-compulsive PDs were associated with CVD (all p ≤ 0.01) among younger adults. Paranoid, antisocial, borderline and avoidant PDs and younger adults with schizoid, schizotypal and obsessive-compulsive PDs were each associated with arthritis (all p ≤ 0.01). Significant associations were seen between paranoid, schizoid and schizotypal PDs and diabetes (all p ≤ 0.01). Finally, schizotypal, antisocial, borderline and narcissistic PDs were associated with GI conditions (all p ≤ 0.01).

CONCLUSIONS

PDs were consistently associated with physical conditions. Investigation of PDs and their relationship with physical health outcomes warrant further research attention as these findings have important clinical implications.

摘要

目的

研究人格障碍(PDs)与慢性躯体共病之间关系的研究较少。因此,我们在美国成年人的一项全国代表性调查中,研究了个体PDs和PD聚类与各种常见疾病组[心血管疾病(CVD)、糖尿病、关节炎和胃肠道疾病(GI)]之间的关联。

方法

本研究使用了全国酒精及相关疾病流行病学调查第1波和第2波的汇总数据(n = 34,653;≥20岁)。使用《酒精使用障碍及相关残疾访谈表-精神障碍诊断与统计手册》第四版评估PDs。躯体状况基于健康专业人员诊断的自我报告。未调整和调整后的逻辑回归分析了PDs与躯体状况之间的关系。

结果

调整(社会人口学因素、过去一年的情绪、焦虑和物质使用障碍)后,A、B和C类PDs均与躯体状况相关(所有p≤0.01)。在个体PDs中,分裂样、分裂型、自恋型、边缘型和强迫型PDs在年轻成年人中与CVD相关(所有p≤0.01)。偏执型、反社会型、边缘型和回避型PDs以及患有分裂样、分裂型和强迫型PDs的年轻成年人均与关节炎相关(所有p≤0.01)。偏执型、分裂样和分裂型PDs与糖尿病之间存在显著关联(所有p≤0.01)。最后,分裂型、反社会型、边缘型和自恋型PDs与GI疾病相关(所有p≤0.01)。

结论

PDs与躯体状况始终相关。鉴于这些发现具有重要的临床意义,对PDs及其与身体健康结果的关系进行研究值得进一步关注。

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