Zanarini M C, Gunderson J G, Frankenburg F R
Psychosocial Research Program, McLean Hospital, Belmont, MA 02178.
Compr Psychiatry. 1989 Mar-Apr;30(2):149-56. doi: 10.1016/0010-440x(89)90067-9.
The Axis I phenomenology of 50 outpatients meeting both Diagnostic Interview for Borderlines (DIB) and DSM-III criteria for Borderline Personality Disorder (BPD), 29 outpatients meeting DSM-III criteria for Antisocial Personality Disorder (APD), and 26 outpatients meeting DSM-III criteria for Dsythymic Disorder as well as DSM-III criteria for some other type of Axis II disorder (dysthymic OPD) was assessed blind to clinical diagnosis using the Structured Clinical Interview for DSM-III (SCID). Borderlines were significantly more likely than antisocial controls to have met DSM-III criteria for an affective disorder, particularly Dysthymic Disorder, and an anxiety disorder. They were also significantly more likely than dysthymic OPD controls but significantly less likely than antisocial controls to have met DSM-III criteria for alcohol abuse/dependence and drug abuse/dependence. The authors conclude that: (1) the link between BPD and unipolar affective disorders is less specific than previously suggested, and (2) there is a link between BPD and impulse disorders that may be of equal, if not greater, importance.
对50名同时符合边缘型人格障碍诊断访谈(DIB)和《精神疾病诊断与统计手册》第三版(DSM-III)边缘型人格障碍(BPD)标准的门诊患者、29名符合DSM-III反社会人格障碍(APD)标准的门诊患者以及26名符合DSM-III恶劣心境障碍标准以及其他某种轴II障碍(恶劣心境性人格障碍)标准的门诊患者,采用《精神疾病诊断与统计手册》第三版结构化临床访谈(SCID),在对临床诊断不知情的情况下进行评估。边缘型人格障碍患者比反社会对照者更有可能符合DSM-III情感障碍标准,尤其是恶劣心境障碍和焦虑障碍标准。与恶劣心境性人格障碍对照者相比,他们符合DSM-III酒精滥用/依赖和药物滥用/依赖标准的可能性也显著更高,但比反社会对照者显著更低。作者得出结论:(1)BPD与单相情感障碍之间的联系不如先前认为的那么具有特异性;(2)BPD与冲动障碍之间存在联系,这一联系即便不更为重要,也可能同等重要。