VAN Riel Laura, Ingenhoven Theo J M, VAN Dam Quin D, Polak Marike G, Vollema Meinte G, Willems Anne E, Berghuis Han, VAN Megen Harold
VAN RIEL: Novarum Centre for Eating Disorders and Obesity, Arkin Institute of Mental Health, Amsterdam, The Netherlands INGENHOVEN: Centre for Psychotherapy, Pro Persona, Lunteren, The Netherlands VAN DAM: Centre for Psychology and Psychotherapy Q.D. van Dam, Leiden, The Netherlands POLAK: Institute of Psychology, Erasmus University Rotterdam, The Netherlands VOLLEMA: Centre for Psychology, De Binnenkijk, Centre for psychotherapy, diagnostics and supervision, Ermelo, The Netherlands WILLEMS: Research Centre GZZ Centraal, Amersfoort, The Netherlands BERGHUIS: Institute of Mental Health, Pro Persona, Tiel, The Netherlands VAN MEGEN: Institute of Mental Health GGZ Centraal, Ermelo, The Netherlands.
J Psychiatr Pract. 2017 Mar;23(2):101-113. doi: 10.1097/PRA.0000000000000225.
Considerable overlap in symptoms between patients with borderline personality disorder (BPD) and schizotypal personality disorder (STPD) complicates personality diagnostics. Yet very little is known about the level of psychodynamic functioning of both personality disorders. Psychodynamic assessment procedures may specify personality characteristics relevant for differential diagnosis and treatment planning. In this cross-sectional study we explored the differences and similarities in level of personality functioning and psychodynamic features of patients with severe BPD or STPD. In total, 25 patients with BPD and 13 patients with STPD were compared regarding their level of personality functioning (General Assessment of Personality Disorder), current quasipsychotic features (Schizotypal Personality Questionnaire), and psychodynamic functioning [Developmental Profile (DP) interview and Developmental Profile Inventory (DPI) questionnaire]. Both groups of patients showed equally severe impairments in the level of personality functioning and the presence of current quasipsychotic features. As assessed by the DP interview, significant differential psychodynamic patterns were found on the primitive levels of functioning. Moreover, subjects with BPD had significantly higher scores on the adaptive developmental levels. However, the self-questionnaire DPI was not able to elucidate all of these differences. In conclusion, our study found significant differences in psychodynamic functioning between patients with BPD and STPD as assessed with the DP interview. In complicated diagnostic cases, personality assessment by psychodynamic interviewing can enhance subtle but essential differentiation between BPD and STPD.
边缘型人格障碍（BPD）患者和分裂型人格障碍（STPD）患者在症状上存在相当大的重叠，这使得人格诊断变得复杂。然而，对于这两种人格障碍的心理动力功能水平，我们知之甚少。心理动力评估程序可能会明确与鉴别诊断和治疗计划相关的人格特征。在这项横断面研究中，我们探讨了重度BPD或STPD患者在人格功能水平和心理动力特征方面的差异与相似之处。总共比较了25名BPD患者和13名STPD患者的人格功能水平（人格障碍总体评估）、当前的类精神病特征（分裂型人格问卷）以及心理动力功能[发展概况（DP）访谈和发展概况量表（DPI）问卷]。两组患者在人格功能水平和当前类精神病特征的存在方面均表现出同样严重的损害。通过DP访谈评估发现，在原始功能水平上存在显著的差异心理动力模式。此外，BPD患者在适应性发展水平上的得分显著更高。然而，自我问卷DPI无法阐明所有这些差异。总之，我们的研究发现，通过DP访谈评估，BPD患者和STPD患者在心理动力功能方面存在显著差异。在复杂的诊断案例中，通过心理动力访谈进行人格评估可以增强BPD和STPD之间微妙但至关重要的区分。
