Matthies Swantje D, Philipsen Alexandra
Department of Psychiatry & Psychotherapy, Clinic of Mental illnesses, University Medical Centre, Hauptstr. 5, D-79104 Freiburg, Germany.
Borderline Personal Disord Emot Dysregul. 2014 Apr 10;1:3. doi: 10.1186/2051-6673-1-3. eCollection 2014.
Considerable overlap in diagnostic criteria and shared psychopathologic symptoms in attention deficit hyperactivity disorder (ADHD) and borderline personality disorder (BPD) have stimulated research activities in this field. Longitudinal studies have shown that BPD is frequently diagnosed in adult patients who had been diagnosed with ADHD in childhood. The question of whether ADHD and BPD randomly co-occur as comorbidities, have similar origins or share common pathological mechanisms remains unresolved. Some authors suggest that ADHD contributes to the development of BPD via various mechanisms, and therefore consider it a risk factor for later BPD development. In this article the evidence for the co-occurrence of these disorders will be reviewed as well as studies on their common genetic and environmental influences. Temperamental and developmental issues will be reviewed, and shared features such as impulsivity and emotion dysregulation discussed. From a therapeutic perspective, few studies have investigated psychotherapeutic treatment of the comorbid condition, though the issue is highly important to the management of patients suffering from both disorders. Some thought is given to how therapeutic methods and approaches can be modified to benefit patients, and to their possible succession.
注意缺陷多动障碍(ADHD)与边缘型人格障碍(BPD)在诊断标准和共有的精神病理症状方面存在相当大的重叠,这激发了该领域的研究活动。纵向研究表明,BPD在童年期被诊断为ADHD的成年患者中经常被诊断出来。ADHD和BPD是作为共病随机同时出现、具有相似起源还是共享共同的病理机制,这个问题仍未得到解决。一些作者认为,ADHD通过各种机制促成BPD的发展,因此将其视为后期BPD发展的一个风险因素。在本文中,将回顾这些疾病同时出现的证据以及关于它们共同的遗传和环境影响的研究。将回顾气质和发育问题,并讨论冲动性和情绪调节障碍等共同特征。从治疗角度来看,很少有研究调查共病情况的心理治疗,尽管这个问题对同时患有这两种疾病的患者的管理非常重要。本文还会思考如何调整治疗方法和途径以造福患者,以及它们可能的先后顺序。