Rodríguez-Delgado Andrés, Fresán Ana, Miranda Edgar, Garza-Villarreal Eduardo, Alcalá-Lozano Ruth, Duque-Alarcón Xóchitl, Balducci Thania, Arango de Montis Iván
Clínica de Trastorno Límite de la Personalidad, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz , Mexico City , Mexico.
Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz , Mexico City , Mexico.
Nord J Psychiatry. 2019 Nov;73(8):509-514. doi: 10.1080/08039488.2019.1658127. Epub 2019 Aug 27.
To identify personality disorders comorbid with borderline personality disorder (BPD) that may confer greater risk for the presence of severe dissociative experiences. Three hundred and one outpatients with a primary diagnosis of BPD were evaluated using the Structured Clinical Interview for DSM-IV Axis II personality disorders, the Borderline Evaluation of Severity Over Time (BEST) and the Dissociative Experiences Scale (DES). The most frequent personality disorders comorbid to BPD were paranoid (83.2%, = 263) and depressive (81.3%, = 257). The mean BEST and DES total score were 43.3 ( = 11.4, range 15-69) and 28.6 ( = 19.8, range 0-98), respectively. We categorized the sample into patients with and without severe dissociative experiences (41% were positive). A logistic regression model revealed that Schizotypal, Obsessive-compulsive and Antisocial personality disorders conferred greater risk for the presence of severe dissociative experiences. Our results suggest that a large proportion of patients with BPD present a high rate of severe dissociative experiences and that some clinical factors such as personality comorbidity confer greater risk for severe dissociation, which is related to greater dysfunction and suffering, as well as a worse progression of the BPD.
识别与边缘型人格障碍（BPD）共病的人格障碍，这些人格障碍可能会增加出现严重分离性体验的风险。对301名初步诊断为BPD的门诊患者进行评估，使用《精神疾病诊断与统计手册》第四版轴II人格障碍的结构化临床访谈、边缘型人格障碍严重程度随时间变化评估（BEST）以及分离性体验量表（DES）。与BPD共病最常见的人格障碍是偏执型（83.2%，n = 263）和抑郁型（81.3%，n = 257）。BEST和DES总分的平均值分别为43.3（n = 11.4，范围15 - 69）和28.6（n = 19.8，范围0 - 98）。我们将样本分为有和没有严重分离性体验的患者（41%为阳性）。逻辑回归模型显示，分裂型、强迫型和反社会型人格障碍会增加出现严重分离性体验的风险。我们的结果表明，很大一部分BPD患者存在高比例的严重分离性体验，并且一些临床因素如人格共病会增加严重分离的风险，这与更大的功能障碍和痛苦以及BPD更差的病程进展有关。
