Özel Beren, Karakaya Ezgi, Köksal Fazilet, Altinoz Ali Ercan, Yilmaz-Karaman Imran Gokcen
Department of Psychiatry, Faculty of Medicine, Baskent University, Ankara, Türkiye.
Department of Psychiatry, Faculty of Medicine, Ankara University, Ankara, Türkiye.
Arch Womens Ment Health. 2025 Jun;28(3):563-571. doi: 10.1007/s00737-024-01519-0. Epub 2024 Oct 4.
Antisocial Personality Disorder (ASPD) and Borderline Personality Disorder (BPD) challenge mental health professionals with similar maladaptive behaviors. However, these two disorders differ regarding available evidence-based treatments. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been criticized as being gender-biased diagnostic construct. The present study aimed to determine the gender bias of ASPD and BPD among Turkish psychiatrists.
Three case vignettes were randomly presented as male or female to the psychiatrists online. The first case was a patient with schizophrenia case to confirm the participant's ability to diagnose. The second case was a patient with ASPD, and the third one was a patient with BPD.
Two hundred fifty participants diagnosed the first case correctly (n = 250). The results with statistical significance demonstrated that a female case with ASPD was 5.1 times more likely to get misdiagnosed than a male case with ASPD (p˂0.0001).
Categorical classification of personality disorders in DSM leads to gender bias in in the diagnosis of ASPD and BPD. The present study shows that female cases with ASPD are misdiagnosed as BPD which may result in treatment attempts without evidence.
反社会型人格障碍（ASPD）和边缘型人格障碍（BPD）存在相似的适应不良行为，给心理健康专业人员带来了挑战。然而，这两种障碍在可用的循证治疗方法上有所不同。《精神疾病诊断与统计手册》（DSM）被批评为存在性别偏见的诊断结构。本研究旨在确定土耳其精神科医生中ASPD和BPD的性别偏见情况。
向精神科医生在线随机呈现三个病例 vignettes，分别设定为男性或女性。第一个病例是精神分裂症患者，用于确认参与者的诊断能力。第二个病例是ASPD患者，第三个病例是BPD患者。
250名参与者正确诊断了第一个病例（n = 250）。具有统计学意义的结果表明，女性ASPD病例被误诊的可能性是男性ASPD病例的5.1倍（p < 0.0001）。
DSM中人格障碍的分类诊断在ASPD和BPD的诊断中导致了性别偏见。本研究表明，女性ASPD病例被误诊为BPD，这可能导致进行无循证依据的治疗尝试。
