环境影响在边缘型人格障碍与注意力缺陷/多动障碍复杂关系中的作用：近期研究结果综述
The role of environmental influences in the complex relationship between borderline personality disorder and attention-deficit/hyperactivity disorder: review of recent findings.
作者信息
Calvo Natalia, Lara Benjamin, Serrat Laia, Pérez-Rodríguez Violeta, Andión Òscar, Ramos-Quiroga Josep A, Ferrer Marc
机构信息
1BPD Program, Psychiatry Department, Hospital Universitary Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
2Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
出版信息
Borderline Personal Disord Emot Dysregul. 2020 Jan 6;7:2. doi: 10.1186/s40479-019-0118-z. eCollection 2020.
BACKGROUND
In recent years, the existence of possible developmental pathways from childhood Attention-Deficit/Hyperactivity Disorder (ADHD) to adult Borderline Personality Disorder (BPD) has been suggested. The existence of common genetic factors has been described but there is little evidence on the role of environmental factors in the possible transition from one disorder to another throughout life. The main goal of this work is to review the literature about the existing evidence on childhood traumas as factors that mediate the risk of developing BPD in children with ADHD.
METHODS
A literature search was conducted using PubMed, Science Direct and PsychInfo databases. Criteria included studies of BPD and ADHD relationships and childhood traumas as environmental influences from epidemiological or clinical samples.
RESULTS
The review only identified 4 studies that matched the search criteria. All studies retrospectively analyzed childhood traumas, and adult patients with BPD, with or without comorbid ADHD, were the most frequently mentioned. The analyzed evidence reinforces the relationship between the number of childhood traumas and higher clinical severity. Three of these analyzed studies describe an increased the risk of children with ADHD who report emotional and sexual traumatic experiences to develop BPD in adulthood.
CONCLUSIONS
The experience of traumatic childhood events, especially those of an emotional type, may have a mediating effect of an increased risk of developing adult BPD in childhood ADHD patients. However, to consider them as risk factors, more studies, and especially longitudinal studies, are necessary to clarify the probable transactional process between the two disorders. Evidence from these studies may be helpful to develop early intervention programs to reduce the functional impairment associated with the two disorders.
背景
近年来，有人提出儿童注意力缺陷多动障碍（ADHD）到成人边缘型人格障碍（BPD）可能存在发展路径。虽然已经描述了共同遗传因素的存在，但关于环境因素在一生中从一种障碍向另一种障碍可能转变过程中的作用，证据很少。这项工作的主要目标是回顾有关童年创伤作为介导ADHD儿童患BPD风险因素的现有证据的文献。
方法
使用PubMed、Science Direct和PsychInfo数据库进行文献检索。标准包括对BPD和ADHD关系以及童年创伤作为来自流行病学或临床样本的环境影响的研究。
结果
该综述仅确定了4项符合检索标准的研究。所有研究均回顾性分析了童年创伤，最常提及的是患有或未患有共病ADHD的成年BPD患者。分析的证据强化了童年创伤数量与更高临床严重程度之间的关系。其中三项分析研究描述了报告有情感和性创伤经历的ADHD儿童成年后患BPD的风险增加。
结论
童年创伤事件的经历，尤其是情感类型的经历，可能对童年ADHD患者成年后患BPD的风险增加具有中介作用。然而，要将它们视为风险因素，需要更多的研究，尤其是纵向研究，以阐明这两种障碍之间可能的相互作用过程。这些研究的证据可能有助于制定早期干预计划，以减少与这两种障碍相关的功能损害。
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