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
IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/-Barwon Health, Ryrie Street, PO 281, Geelong, VIC, 3220, Australia,
Soc Psychiatry Psychiatr Epidemiol. 2015 May;50(5):807-20. doi: 10.1007/s00127-014-0974-1. Epub 2014 Oct 15.
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.
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.
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).
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.
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。
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。
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）。
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。
