Baryshnikov Ilya, Joffe Grigori, Koivisto Maaria, Melartin Tarja, Aaltonen Kari, Suominen Kirsi, Rosenström Tom, Näätänen Petri, Karpov Boris, Heikkinen Martti, Isometsä Erkki
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.
J Affect Disord. 2017 Mar 1;210:82-89. doi: 10.1016/j.jad.2016.12.004. Epub 2016 Dec 14.
Co-occurring borderline personality disorder (BPD) features have a marked impact on treatment of patients with mood disorders. Overall, high neuroticism, childhood traumatic experiences (TEs) and insecure attachment are plausible aetiological factors for BPD. However, their relationship with BPD features specifically among patients with mood disorders remains unclear. We investigated these relationships among unipolar and bipolar mood disorder patients.
As part of the Helsinki University Psychiatric Consortium study, the McLean Screening Instrument (MSI), the Experiences in Close Relationships-Revised (ECR-R), the Short Five (S5) and the Trauma and Distress Scale (TADS) were filled in by patients with mood disorders (n=282) in psychiatric care. Correlation coefficients between total scores of scales and their dimensions were estimated, and multivariate regression (MRA) and mediation analyses were conducted.
Spearman's correlations were strong (rho=0.58; p<0.001) between total scores of MSI and S5 Neuroticism and moderate (rho=0.42; p<0.001) between MSI and TADS as well as between MSI and ECR-R Attachment Anxiety. In MRA, young age, S5 Neuroticism and TADS predicted scores of MSI (p<0.001). ECR-R Attachment Anxiety mediated 33% (CI=17-53%) of the relationships between TADS and MSI.
Cross-sectional questionnaire study.
We found moderately strong correlations between self-reported BPD features and concurrent high neuroticism, reported childhood traumatic experiences and Attachment Anxiety also among patients with mood disorders. Independent predictors for BPD features include young age, frequency of childhood traumatic experiences and high neuroticism. Insecure attachment may partially mediate the relationship between childhood traumatic experiences and borderline features among mood disorder patients.
共病的边缘性人格障碍（BPD）特征对心境障碍患者的治疗有显著影响。总体而言，高神经质、童年创伤经历（TEs）和不安全依恋是BPD可能的病因因素。然而，它们与心境障碍患者中BPD特征的关系仍不明确。我们调查了单相和双相心境障碍患者之间的这些关系。
作为赫尔辛基大学精神病学联盟研究的一部分，心境障碍患者（n = 282）在精神科护理中填写了麦克林筛查工具（MSI）、亲密关系经历修订版（ECR-R）、简版大五人格量表（S5）和创伤与痛苦量表（TADS）。估计了各量表总分与其维度之间的相关系数，并进行了多元回归（MRA）和中介分析。
MSI总分与S5神经质总分之间的斯皮尔曼相关性很强（rho = 0.58；p < 0.001），MSI与TADS以及MSI与ECR-R依恋焦虑之间的相关性中等（rho = 0.42；p < 0.001）。在MRA中，年轻、S5神经质和TADS预测了MSI得分（p < 0.001）。ECR-R依恋焦虑介导了TADS与MSI之间33%（CI = 17 - 53%）的关系。
横断面问卷调查研究。
我们发现，在心境障碍患者中，自我报告的BPD特征与同时存在的高神经质、报告的童年创伤经历和依恋焦虑之间存在中等强度的相关性。BPD特征的独立预测因素包括年轻、童年创伤经历的频率和高神经质。不安全依恋可能部分介导了心境障碍患者童年创伤经历与边缘性特征之间的关系。
