Wieland Jannelien, Zitman Frans G
Kristal Centre for Psychiatry and Intellectual Disability, Rivierduinen, Postbus 582, 2300 AN Leiden, The Netherlands.
Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands.
Res Dev Disabil. 2016 Apr-May;51-52:153-9. doi: 10.1016/j.ridd.2016.01.007. Epub 2016 Jan 29.
In most countries, people with borderline intellectual functioning (BIF) are not considered a separate group in mental health care. There is little to no research on the impact of BIF on the presentation, nature and severity of mental health problems. The aim of the present exploratory study was to compare, in a naturalistic setting of patients referred to secondary care, symptom profiles of patients with BIF diagnosed with either major depressive disorder (MDD) or posttraumatic stress disorder (PTSD) to patients from regular mental health care (RMHC) and patients with Mild ID diagnosed with the same disorders.
We used a cohort of adolescent and adult outpatients (aged 16-88) with or without BIF diagnosed with a primary diagnosis MDD or PTSD. Primary outcome was the nature and severity of psychopathological symptoms assessed at baseline using the Brief Symptom Inventory. All outcomes were adjusted for gender and age.
Results showed that BIF patients with a primary diagnosis MDD reported less severe symptoms on BSI Total and the subscales Depression, Obsession-Compulsion and Psychoticism than patients from regular mental health care (RMHC). There were no statistically significant differences in reported symptom severity on BSI Total and the different BSI subscales between BIF patients with PTSD and either patients from RMHC or patients with Mild ID. Patients Mild ID, did report significantly less severe symptoms on the subscale Depression and on the subscale Psychoticism than patients from RMHC.
Since there were no other published studies into symptom profiles in patients with BIF compared to either patients with higher or lower levels of cognitive functioning, the study was mainly exploratory in nature, providing direction for future research. Results indicate that symptom profiles did not widely differ, but that there might be some characteristics unique to patients BIF separating them as a group from both patients from RMHC and patients with Mild ID.
在大多数国家，边缘智力功能（BIF）患者在精神卫生保健中不被视为一个单独的群体。关于BIF对心理健康问题的表现、性质和严重程度的影响，几乎没有相关研究。本探索性研究的目的是，在转至二级护理的患者的自然环境中，比较被诊断患有重度抑郁症（MDD）或创伤后应激障碍（PTSD）的BIF患者与常规精神卫生保健（RMHC）患者以及被诊断患有相同疾病的轻度智力障碍（Mild ID）患者的症状特征。
我们使用了一组青少年和成人门诊患者（年龄在16 - 88岁之间），他们被诊断患有或未患有BIF，且原发性诊断为MDD或PTSD。主要结局是使用简明症状量表在基线时评估的精神病理症状的性质和严重程度。所有结局均根据性别和年龄进行了调整。
结果显示，原发性诊断为MDD的BIF患者在简明症状量表总分以及抑郁、强迫和精神病性分量表上报告的症状严重程度低于常规精神卫生保健（RMHC）患者。患有PTSD的BIF患者与RMHC患者或轻度智力障碍患者在简明症状量表总分和不同简明症状量表分量表上报告的症状严重程度没有统计学上的显著差异。轻度智力障碍患者在抑郁分量表和精神病性分量表上报告的症状严重程度确实显著低于RMHC患者。
由于与认知功能较高或较低的患者相比，目前尚无其他关于BIF患者症状特征的已发表研究，该研究主要是探索性的，为未来研究提供了方向。结果表明，症状特征没有广泛差异，但BIF患者可能有一些独特的特征，使他们作为一个群体与RMHC患者和轻度智力障碍患者区分开来。
