von Zerssen D, Tauscher R, Pössl J
Max Planck Institute of Psychiatry, Clinical Institute, Munich, FRG.
J Affect Disord. 1994 Sep;32(1):61-72. doi: 10.1016/0165-0327(94)90062-0.
The hypothesis of a relationship between types of premorbid personality and subtypes of an affective illness was tested on the basis of a diagnostically 'blind' assignment of biographical case history data on patients' premorbid development to patterns of personality traits. Data sets of 261 cases with various psychiatric disorders were examined. The rater (R.T.) had to score each item in a list of traits relevant for the diagnosis of the types that had been conceived by D.v.Z. and J.P. The assignment of the ratings to the type concepts was then performed by means of a computer programme. The results regarding the distribution of types over the clinical diagnoses yielded a statistically significant association of the 'affective types' of premorbid personality ('melancholic type' and 'manic type') with affective disorders and the 'neurotoid types' ('anxious insecure type' and 'nervous tense type') with non-affective disorders. Previous findings on the basis of a global rating of types in a smaller sample (n = 42) regarding personality types and subtypes of an affective illness could be replicated by means of the new, operationalized procedure in an enlarged sample (n = 80): On the one hand, a marked preponderance of the 'manic type' of personality was found in bipolar I patients, particularly pronounced in those with a predominantly manic course of the disorder; on the other hand, the 'melancholic type' of personality prevailed in bipolar II and unipolar depressive patients.
基于对患者病前发展的传记式病例史数据进行“盲法”诊断分配，将其对应到人格特质模式，对病前人格类型与情感性疾病亚型之间的关系假说进行了检验。研究考察了261例患有各种精神障碍患者的数据集。评分者（R.T.）必须对D.v.Z.和J.P.所构想的与各类型诊断相关的一系列特质中的每个项目进行评分。然后通过计算机程序将评分分配到类型概念中。关于各类型在临床诊断中的分布结果显示，病前人格的“情感类型”（“抑郁型”和“躁狂型”）与情感性障碍之间存在统计学上的显著关联，而“类神经症类型”（“焦虑不安全型”和“紧张神经质型”）与非情感性障碍之间存在关联。在一个较小样本（n = 42）中基于对人格类型和情感性疾病亚型的整体评分的先前研究结果，通过新的、可操作的程序在扩大样本（n = 80）中得以复制：一方面，在双相I型患者中发现“躁狂型”人格明显占优势，在那些以躁狂发作为主的病程患者中尤为明显；另一方面，“抑郁型”人格在双相II型和单相抑郁患者中占主导。
