López-Villatoro José Manuel, Díaz-Marsá M, Gálvez-Merlin A, De la Higuera-González P, Carrasco J L
Health Research Institute, Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.
Early Interv Psychiatry. 2025 Jan;19(1):e13593. doi: 10.1111/eip.13593. Epub 2024 Jul 15.
Deficits in mentalization have been described in several mental disorders, but information is still scarce and ambiguous about the types of mentalization errors in each disorder and their specificity and severity in borderline personality disorder (BPD). Due to the high comorbidity between this disorder and axis I disorders, the aim of this work is to study differences in mentalization responses in BPD considering the different comorbidity profiles with other disorders.
A total of 141 BPD patients were evaluated using The Mini-International Neuropsychiatric Interview (MINI), to identify comorbid axis I disorders. Mentalizing ability was assessed by the Movie for the Assessment of Social Cognition (MASC). Statistical associations were analysed into the different variables.
Patients with comorbid BPD and anorexia nervosa (AN), suicidal behaviour disorder or post-traumatic stress disorder (PTSD) respectively presented higher overmentalization, undermentalization and absence of mentalization errors, compared with patients with BPD without comorbidity.
Results show that BPD comorbidity with AN, suicidal behaviour disorder and PTSD affect to the types and severity of mentalizing deficits observed in these patients. This study highlights the importance of the assessment and treatment of axis I comorbid disorders in borderline personality disorder, with the objective of shaping personalized treatment for every patient.
多种精神障碍中均存在心理化缺陷,但关于每种障碍中心理化错误的类型及其在边缘型人格障碍(BPD)中的特异性和严重程度,信息仍然匮乏且模糊。由于该障碍与轴I障碍之间的高共病率,本研究旨在探讨考虑到与其他障碍的不同共病情况时,BPD患者心理化反应的差异。
使用《迷你国际神经精神访谈》(MINI)对总共141名BPD患者进行评估,以确定共病的轴I障碍。通过社会认知评估影片(MASC)评估心理化能力。对不同变量进行统计关联分析。
与无共病的BPD患者相比,共病BPD与神经性厌食症(AN)、自杀行为障碍或创伤后应激障碍(PTSD)的患者分别表现出更高的过度心理化、心理化不足和无心理化错误。
结果表明,BPD与AN、自杀行为障碍和PTSD的共病会影响这些患者中观察到的心理化缺陷的类型和严重程度。本研究强调了在边缘型人格障碍中评估和治疗轴I共病障碍的重要性,目的是为每个患者制定个性化治疗方案。