Brager-Larsen Anne, Zeiner Pål, Mehlum Lars
Child and Adolescent Mental Health Research Unit, Division of Mental Health and Addiction, Department of Research and Innovation, Oslo University Hospital, Sognsvannsveien 12, Bygg 12, N-0372, Oslo, Norway.
National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Borderline Personal Disord Emot Dysregul. 2023 Sep 14;10(1):26. doi: 10.1186/s40479-023-00234-z.
Borderline personality disorder (BPD) is a severe mental disorder frequently seen in individuals with recurrent self-harm behaviour. To what extent there are distinguishing characteristics between self-harming adolescents who meet the criteria for a full diagnosis of BPD, a sub-threshold number of BPD criteria and those who don't have BPD, with respect to clinical characteristics, is still uncertain and could have important clinical implications.
Data from 103 adolescents with recurrent self-harm behaviour recruited from child and adolescent psychiatric outpatient clinics were collected through clinical interviews and self-reports. Bivariate analyses comparing participants with or without a diagnosis of BPD were performed. Group differences based on the number of BPD criteria fulfilled (few-if-any BPD: 0-2 criteria, sub-threshold BPD: 3-4 criteria, full-syndrome BPD: 5 or more criteria) were tested and regression analyses performed.
Adolescents with a diagnosis of BPD (28.2%) had significantly higher numbers of co-morbid DSM-5 disorders, suicide attempts and self-harm methods. They also reported significantly higher levels of suicidal ideation, depression, anxiety and impulsivity, compared with adolescents without BPD. Adolescents with sub-threshold BPD (20.4%) place themselves in the intermediate position between participants with full-syndrome BPD and participants with few-if-any BPD, in terms of these symptoms. Higher levels of emotional regulation difficulties and a lower level of global functioning were significantly associated with fulfilling a higher number of BPD criteria.
Adolescents with recurrent self-harm who meet diagnostic criteria for a full-syndrome BPD or sub-threshold BPD seem to have difficulties within the same spectrum. They seem dimensionally, but not categorically, different with respect to the severity of their difficulties. These adolescents need interventions aimed at their dysfunctional self-harm behaviour, emotional regulation difficulties and BPD symptoms at an earlier, rather than at a later stage of symptom development.
边缘型人格障碍（BPD）是一种严重的精神障碍，常见于有反复自伤行为的个体。在临床特征方面，符合BPD完全诊断标准的自伤青少年、符合BPD亚阈值标准数量的青少年以及不符合BPD标准的青少年之间在多大程度上存在区别特征仍不确定，且可能具有重要的临床意义。
从儿童和青少年精神科门诊招募了103名有反复自伤行为的青少年，通过临床访谈和自我报告收集数据。对有或无BPD诊断的参与者进行双变量分析。测试基于满足的BPD标准数量（极少或无BPD：0 - 2条标准，亚阈值BPD：3 - 4条标准，完全综合征BPD：5条或更多标准）的组间差异，并进行回归分析。
被诊断为BPD的青少年（28.2%）共病DSM - 5障碍、自杀未遂和自伤方式的数量显著更高。与无BPD的青少年相比，他们报告的自杀意念、抑郁、焦虑和冲动水平也显著更高。在这些症状方面，亚阈值BPD的青少年（2并在满足更多BPD标准的情况下，情绪调节困难水平较高和整体功能水平较低与显著相关。
符合完全综合征BPD或亚阈值BPD诊断标准的反复自伤青少年似乎在同一范围内存在困难。就其困难的严重程度而言，他们似乎在维度上而非类别上有所不同。这些青少年需要在症状发展的早期而非后期针对其功能失调的自伤行为、情绪调节困难和BPD症状进行干预。 0.4%）处于完全综合征BPD参与者和极少或无BPD参与者之间的中间位置。
