Centre for Mental Health, Imperial College, London, UK.
World Health Organization, Geneva, Switzerland.
Lancet. 2015 Feb 21;385(9969):717-26. doi: 10.1016/S0140-6736(14)61995-4. Epub 2015 Feb 20.
Personality disorders are common and ubiquitous in all medical settings, so every medical practitioner will encounter them frequently. People with personality disorder have problems in interpersonal relationships but often attribute them wrongly to others. No clear threshold exists between types and degrees of personality dysfunction and its pathology is best classified by a single dimension, ranging from normal personality at one extreme through to severe personality disorder at the other. The description of personality disorders has been complicated over the years by undue adherence to overlapping and unvalidated categories that represent specific characteristics rather than the core components of personality disorder. Many people with personality disorder remain undetected in clinical practice and might be given treatments that are ineffective or harmful as a result. Comorbidity with other mental disorders is common, and the presence of personality disorder often has a negative effect on course and treatment outcome. Personality disorder is also associated with premature mortality and suicide, and needs to be identified more often in clinical practice than it is at present.
人格障碍在所有医疗环境中都很常见且普遍存在,因此每个医疗从业者都会经常遇到。人格障碍患者的人际关系存在问题,但他们往往错误地将其归咎于他人。人格功能障碍的类型和程度之间没有明确的界限,其病理学最好通过单一维度来分类,从一端的正常人格到另一端的严重人格障碍。多年来,人格障碍的描述因过分坚持重叠且未经验证的类别而变得复杂,这些类别代表特定特征而不是人格障碍的核心成分。在临床实践中,许多人格障碍患者未被发现,因此可能会接受无效或有害的治疗。与其他精神障碍共病很常见,人格障碍的存在通常会对病程和治疗结果产生负面影响。人格障碍也与过早死亡和自杀有关,因此在临床实践中需要比现在更频繁地识别它。