Zanarini M C, Frankenburg F R, Gunderson J G
Psychosocial Research Program, McLean Hospital, Belmont, MA 02178.
Compr Psychiatry. 1988 Jul-Aug;29(4):372-8. doi: 10.1016/0010-440x(88)90018-1.
The charts 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 Dysthymic Disorder, as well as DSM-III criteria for some other type of Axis II disorder (dysthymic other personality disorder [OPD]) were reviewed blind to proband diagnosis to determine both the percentage of those in each group who had adequate medication trials and the efficacy of those trials. Borderlines were significantly more likely than antisocial controls to have received an adequate trial of some form of medication. They were also significantly more likely than antisocial controls to have received an adequate trial of anxiolytics and antidepressants. However, they were distinguished at the trend level or better from both antisocial and dysthymic OPD controls by their greater likelihood of having received an adequate trial of neuroleptics, lithium, and polypharmacy. The percentage of adequately treated borderlines who experienced some degree of symptom relief was not significantly different than that found in either control group. However, adequately treated borderlines were significantly less likely than adequately treated dysthymic OPD controls to have had a definite response to pharmacotherapy (i.e., shown marked improvement of target symptoms).
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、26名符合DSM - III恶劣心境障碍标准以及其他某种轴II障碍（恶劣心境其他人格障碍[OPD]）标准的门诊患者的病历进行了盲法审查，以确定每组中接受过充分药物试验的患者百分比以及这些试验的疗效。边缘型人格障碍患者比反社会对照组患者更有可能接受某种形式药物的充分试验。他们也比反社会对照组患者更有可能接受抗焦虑药和抗抑郁药的充分试验。然而，在接受抗精神病药、锂盐和联合用药充分试验的可能性方面，他们在趋势水平或更显著水平上与反社会和恶劣心境OPD对照组有所区别。经历了一定程度症状缓解的充分治疗的边缘型人格障碍患者百分比与两个对照组中发现的百分比没有显著差异。然而，充分治疗的边缘型人格障碍患者比充分治疗的恶劣心境OPD对照组患者对药物治疗有明确反应（即目标症状有明显改善）的可能性显著更低。
