Aydın Esat Fahri, Koca Laçin Tuğba
Department of Psychiatry, Atatürk University Faculty of Medicine, Erzurum, Türkiye.
Department of Psychiatry, Ankara Etlik City Hospital, Ankara, Türkiye.
Front Psychiatry. 2024 Oct 10;15:1444583. doi: 10.3389/fpsyt.2024.1444583. eCollection 2024.
In this study, we mainly evaluated the associations of borderline personality disorder (BPD), neuroticism, and childhood trauma with the self-rated and clinician-rated overall functional impairment levels of adult euthymic patients with bipolar disorder-1 (BD-1). In addition, we compared patient and healthy control groups regarding the levels of of childhood trauma, neuroticism, BPD and functional impairment.
In total, 90 euthymic BD-1 patients and 90 healthy controls were enrolled. The Childhood Trauma Questionnaire-Short Form, the neuroticism subscale of the Eysenck Personality Questionnaire Revised-Abbreviated Form, the Borderline Personality Questionnaire, the Functioning Assessment Short Test, and the Sheehan Disability Scale were administered to the participants.
The study revealed that the levels of BPD, neuroticism, emotional abuse, physical abuse, global childhood trauma, self-rated overall functional impairment, all the subdomains of self-rated functional impairment, clinician-rated overall functional impairment, and all the subdomains of clinician-rated functional impairment (except leisure time) were significantly higher in the patients than those in the healthy controls (p < 0.05). Clinician-rated functional impairment levels were significantly correlated with levels of BPD (r = 0.555, p<0.001), neuroticism (r = 0.429, p < 0.001), global childhood trauma (r = 0.391, p <0.001), and all subtypes of childhood trauma except sexual abuse. Self-rated functional impairment levels were significantly correlated with levels of neuroticism (r= 0.289, p = 0.006), physical neglect (r = 0.213, p = 0.044), and BPD (r = 0.557, p < 0.001). In the regression analyses, the self-rated overall functional impairment levels were only significantly associated with the BPD feature levels (β = 0.319, p < 0.001) and the clinician-rated overall functional impairment levels were only significantly associated with the BPD feature levels (β = 0.518, p < 0.001).
The present study's findings suggest that BPD features should be addressed in psychosocial interventions aimed at ameliorating functional impairment in patients with BD-1. Only BPD features were associated with self-rated and clinician-rated overall functional impairment levels in the regression analyses in the BD-1 patients. Performing self-rated and clinician-rated functional impairment assessments in the same clinical trial may give rise to relevant findings in the future.
在本研究中，我们主要评估了边缘型人格障碍（BPD）、神经质和童年创伤与双相情感障碍1型（BD-1）成年缓解期患者的自评及临床医生评定的总体功能损害水平之间的关联。此外，我们比较了患者组和健康对照组在童年创伤、神经质、BPD和功能损害水平方面的差异。
总共招募了90名BD-1缓解期患者和90名健康对照者。对参与者进行了儿童创伤问卷简表、艾森克人格问卷修订简表中的神经质分量表、边缘型人格问卷、功能评估简短测试和希恩残疾量表的测评。
研究显示，患者组的BPD、神经质、情感虐待、身体虐待、总体童年创伤、自评总体功能损害、自评功能损害的所有子领域、临床医生评定的总体功能损害以及临床医生评定功能损害的所有子领域（休闲时间除外）水平均显著高于健康对照组（p<0.05）。临床医生评定的功能损害水平与BPD水平（r = 0.555，p<0.001）、神经质水平（r = 约0.429，p < 0.001）、总体童年创伤水平（r = 0.391，p <0.001）以及除性虐待外的所有童年创伤亚型均显著相关。自评功能损害水平与神经质水平（r= 0.289，p = 0.006）、身体忽视（r = 0.213，p = 0.044）和BPD水平（r = 0.557，p < 0.001）显著相关。在回归分析中，自评总体功能损害水平仅与BPD特征水平显著相关（β = 0.319，p < 0.001），临床医生评定的总体功能损害水平仅与BPD特征水平显著相关（β = 0.518，p < 0.001）。
本研究结果表明，在旨在改善BD-1患者功能损害的心理社会干预中应关注BPD特征。在BD-1患者的回归分析中，只有BPD特征与自评和临床医生评定的总体功能损害水平相关。在同一临床试验中进行自评和临床医生评定的功能损害评估可能会在未来得出相关研究结果。
