Siever L J, Gunderson J G
Schizophr Bull. 1979;5(1):59-86. doi: 10.1093/schbul/5.1.59.
Evidence about the genetic determinants for borderline conditions is reviewed. The research data are too limited and the diagnostic practices followed in existing studies are too varied to allow firm conclusions to be drawn. Thus, the need for new studies starting with well-defined samples of borderline patients is clear. Previous work implicates genetic factors in the etiology of at least some borderlines, but it is unclear that borderlines by any definition will, as a group, have uniformly strong and specific genetic determinants. With further research, partially overlapping subgroups might be defined on the basis of careful examination of borderline patients' clinical characteristics and family histories. Such characterization could have potential clinical value since there may be subgroups of borderlines who respond differently to various psychopharmacologic treatments (Klein 1975) or to exploratory versus ego supportive psychotherapy (Stone 1977). Characterizations based on genetic considerations may have their limitations, since the genetics of these disorders probably involve complex interactions of a variety of factors that may be more or less specifically related to other major diagnostic groups.
本文综述了有关边缘性病症遗传决定因素的证据。研究数据极为有限,且现有研究中采用的诊断方法差异过大,难以得出确切结论。因此,开展以明确界定的边缘性患者样本为起点的新研究迫在眉睫。此前的研究表明,遗传因素至少在部分边缘性病症的病因中起到作用,但目前尚不清楚,无论如何定义,边缘性病症患者群体是否会有统一且强烈的特定遗传决定因素。随着进一步研究,或许可以在仔细考察边缘性患者的临床特征和家族病史的基础上,界定出部分重叠的亚组。这样的特征描述可能具有潜在临床价值,因为可能存在不同亚组的边缘性患者,他们对各种精神药物治疗(Klein,1975年)或探索性与自我支持性心理治疗(Stone,1977年)的反应各异。基于遗传因素的特征描述可能存在局限性,因为这些病症的遗传学可能涉及多种因素的复杂相互作用,这些因素可能或多或少与其他主要诊断类别存在特定关联。