Zanarini Mary C, Frankenburg Frances R, Reich D Bradford, Fitzmaurice Garrett M
From the Department of Psychiatry, Harvard Medical School, Belmont, Mass.; and the Department of Psychiatry, McLean Hospital, Belmont, Mass.
Am J Psychiatry. 2016 Jul 1;173(7):688-94. doi: 10.1176/appi.ajp.2015.15081045. Epub 2016 Feb 12.
The purpose of this study was to determine the cumulative rates of 2- and 4-year remission, and the recurrences that follow them, of 24 symptoms of borderline personality disorder over 16 years of prospective follow-up.
A total of 290 inpatients meeting rigorous criteria for borderline personality disorder and 72 axis II comparison subjects were assessed during their index admission using a series of semistructured diagnostic interviews. The same instruments were readministered at eight contiguous 2-year time periods.
The 12 acute symptoms (e.g., self-mutilation, help-seeking suicide attempts) of borderline personality disorder were more likely to remit for a period of 2 years and for a period of 4 years than the 12 temperamental symptoms (e.g., chronic anger/frequent angry acts, intolerance of aloneness) of this disorder. They were also less likely to recur after a remission lasting 2 years or a remission lasting 4 years.
Taken together, the symptoms of borderline personality disorder are quite fluid, with remissions and recurrences being common. However, the more clinically urgent acute symptoms of borderline personality disorder seem to have a better prognosis than the less turbulent temperamental symptoms of the disorder.
本研究旨在确定在16年的前瞻性随访中，边缘型人格障碍24种症状的2年和4年缓解累积率以及缓解后的复发情况。
共有290名符合边缘型人格障碍严格标准的住院患者和72名轴II对照受试者在其首次入院期间接受了一系列半结构化诊断访谈评估。在连续的8个2年时间段内再次使用相同的工具进行评估。
边缘型人格障碍的12种急性症状（例如，自我伤害、寻求帮助的自杀企图）比该障碍的12种气质性症状（例如，慢性愤怒/频繁愤怒行为、不耐孤独）更有可能在2年和4年内缓解。在持续2年或4年的缓解后，它们复发的可能性也较小。
总体而言，边缘型人格障碍的症状相当不稳定，缓解和复发很常见。然而，边缘型人格障碍临床上更紧急的急性症状似乎比该障碍不那么紊乱的气质性症状预后更好。
