Ten Have Margreet, Verheul Roel, Kaasenbrood Ad, van Dorsselaer Saskia, Tuithof Marlous, Kleinjan Marloes, de Graaf Ron
Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521, VS, Utrecht, The Netherlands.
Centre of Psychotherapy De Viersprong; University of Amsterdam, Amsterdam, The Netherlands.
BMC Psychiatry. 2016 Jul 19;16:249. doi: 10.1186/s12888-016-0939-x.
Despite increasing knowledge of the prevalence of borderline personality disorder (BPD) in the general population, and rising awareness of mental disorders both as a categorical and a dimensional construct, research is still lacking on the prevalence of the number of BPD symptoms and their associated consequences, such as comorbidity, disability, and the use of mental health services) in the general population.
Data were obtained from the second wave of the Netherlands Mental Health Survey and Incidence Study-2 (N = 5303), a nationally representative face-to-face survey of the general population. BPD symptoms were measured by means of questions from the International Personality Disorder Examination. Comorbidity of common mental disorders was assessed with the Composite International Diagnostic Interview version 3.0.
Of the total population studied, 69.9 % reported no BPD symptoms, while 25.2 % had 1-2 symptoms, 3.8 % had 3-4 symptoms, and 1.1 % had ≥ 5 BPD symptoms. The number of BPD symptoms reported was found to be positively associated with not living with a partner, having no paid job, and/or having a comorbid mood, anxiety or substance use disorder. Even after adjustment for sociodemographic characteristics and comorbidity, the number of BPD symptoms turned out to be uniquely associated with disability. It also showed a positive relationship with using services for dealing with mental health problems, although this relationship was strongly affected by the presence of comorbid disorders.
Because even a relatively low number of BPD symptoms appears to be associated with psychiatric comorbidity and functional disability, not only full-blown BPD but also subthreshold levels of BPD symptoms need to be identified in clinical practice and research.
尽管人们对普通人群中边缘型人格障碍（BPD）的患病率了解越来越多，并且对精神障碍作为一种分类和维度结构的认识也在不断提高，但对于普通人群中BPD症状数量的患病率及其相关后果，如共病、残疾以及心理健康服务的使用情况等方面的研究仍然不足。
数据来自荷兰心理健康调查与发病率研究-2的第二轮（N = 5303），这是一项对普通人群具有全国代表性的面对面调查。BPD症状通过国际人格障碍检查表中的问题进行测量。常见精神障碍的共病情况使用复合国际诊断访谈第3.0版进行评估。
在研究的总人口中，69.9%报告没有BPD症状，而25.2%有1 - 2个症状，3.8%有3 - 4个症状，1.1%有≥5个BPD症状。发现报告的BPD症状数量与未与伴侣同住、没有带薪工作以及/或者患有共病性情绪、焦虑或物质使用障碍呈正相关。即使在调整了社会人口学特征和共病情况后，BPD症状数量仍被证明与残疾存在独特关联。它还与使用心理健康问题处理服务呈正相关，尽管这种关系受到共病性障碍存在的强烈影响。
由于即使相对较少数量的BPD症状似乎也与精神共病和功能残疾相关，因此在临床实践和研究中不仅需要识别出全面发作的BPD，还需要识别出BPD症状的阈下水平。
