Herzog T, Stiewe M, Sandholz A, Hartmann A
Abt. Psychotherapie und Psychosomatische Medizin, Albert-Ludwigs-Universität Freiburg.
Psychother Psychosom Med Psychol. 1995 Mar-Apr;45(3-4):97-108.
The comorbidity of personality discorders and eating discorders is an important topic of theoretical and empirical investigation in the field of eating disorders. There is disagreement both concerning the extent of such comorbidity and it's clinical implications for the development and conduct of treatments. After a critical review of the literature up to 12/1994, we report on the results of a standard screening for borderline personality disorder (BPD) with the Diagnostic Interview for Borderlines--Revised (DIB-R) administered by trained and reliable raters in a consecutive sample of 172 first attenders of a regional eating disorders clinic (anorexia, restrictive type [DSM-IV 307.1]: n = 31, anorexia, binge eating/purging type [DSM-IV 307.1]: n = 29, bulimia nervosa [DSM-IV 307.51]: n = 80, eating disorder NOS [DSM-IV 307.50]: n = 32). 8.8% of all eating disordered patients (n = 172) and 10.0% of patients fulfilling the criteria for either anorexia or bulimia (n = 140) met the criteria of a BPD (DIB-R score > or = 8). There were no significant differences between the anorectic and bulimic subgroups. BPD-patients did not differ from the non-BPD patients in the extent or type of their eating disorder. These results differ substantially from those reported in (mostly) smaller and more selected samples. Their nosological and clinical implications are discussed.
人格障碍与饮食失调的共病是饮食失调领域理论和实证研究的一个重要课题。关于这种共病的程度及其对治疗发展和实施的临床意义,目前存在分歧。在对截至1994年12月的文献进行批判性综述之后,我们报告了一项针对边缘型人格障碍(BPD)的标准筛查结果,该筛查采用经修订的边缘型人格诊断访谈(DIB-R),由经过培训且可靠的评估者对一家地区饮食失调诊所的172名初诊患者(神经性厌食症,限制型[DSM-IV 307.1]:n = 31,神经性厌食症,暴饮暴食/清除型[DSM-IV 307.1]:n = 29,神经性贪食症[DSM-IV 307.51]:n = 80,未特定的饮食失调[DSM-IV 307.50]:n = 32)进行连续评估。所有饮食失调患者(n = 172)中有8.8%以及符合厌食症或贪食症标准的患者(n = 140)中有10.0%符合BPD标准(DIB-R评分≥8)。厌食症和贪食症亚组之间无显著差异。BPD患者与非BPD患者在饮食失调的程度或类型上没有差异。这些结果与(大多)规模较小且经过更多筛选的样本中所报告的结果有很大不同。文中讨论了它们在疾病分类学和临床方面的意义。