Fyer M R, Frances A J, Sullivan T, Hurt S W, Clarkin J
Department of Psychiatry, New York Hospital-Cornell Medical Center, NY 10021.
Arch Gen Psychiatry. 1988 Apr;45(4):348-52. doi: 10.1001/archpsyc.1988.01800280060008.
In a retrospective study of 180 inpatients with DSM-III borderline personality disorder (BPD), the degree and direction of psychiatric comorbidity were used to examine the extent to which BPD is a homogeneous entity with clearly defined boundaries. Ninety-one percent of patients with BPD had one additional diagnosis, and 42% had two or more additional diagnoses. Both patients with BPD and controls with other personality disorders had similar rates and directions of comorbidity. The two groups did not differ significantly in prevalence of affective disorder. The DSM-III BPD appears to constitute a very heterogeneous category with unclear boundaries, overlapping with many different disorders but without a specific association with any one Axis I disorder. Comorbidity in patients with BPD may reflect base rates of psychopathology rather than anything inherent to BPD. Future studies should control for comorbidity to ensure homogeneity of comparison groups.
在一项对180例患有DSM-III边缘型人格障碍（BPD）的住院患者的回顾性研究中，精神疾病共病的程度和方向被用于检验BPD在多大程度上是一个界限明确的同质实体。91%的BPD患者有一项额外诊断，42%有两项或更多额外诊断。BPD患者和患有其他人格障碍的对照组在共病率和共病方向上相似。两组在情感障碍患病率上无显著差异。DSM-III BPD似乎构成了一个非常异质的类别，界限不清，与许多不同疾病重叠，但与任何一种轴I障碍均无特定关联。BPD患者的共病可能反映了精神病理学的基础发病率，而非BPD本身固有的任何因素。未来的研究应控制共病情况，以确保比较组的同质性。
