Peselow E D, Sanfilipo M P, Fieve R R, Gulbenkian G
Department of Psychiatry, New York University School of Medicine, NY 10010.
Br J Psychiatry. 1994 Mar;164(3):349-54. doi: 10.1192/bjp.164.3.349.
We investigated whether and how acute depressive symptoms affect the self-report of maladaptive personality traits. Sixty-eight acutely depressed patients underwent the Structured Interview for DSM-III Personality Disorder (SIDP) before and after pharmacological treatment, allowing us to determine whether self-reported maladaptive personality traits are different during depression and after successful clinical recovery. After the initial SIDP administration (during an episode of major depression), patients received desipramine treatment (dose range 150-300 mg/day) over a course of 4-5 weeks before readministration of the SIDP. For those who recovered from their depression (n = 39), cluster III trait scores were significantly lower than those assessed at baseline, and there was a lower frequency of cluster III categorical diagnoses for a personality disorder after treatment than before treatment. Recovered patients also had significantly lower cluster I personality trait scores after treatment as compared with baseline ratings. For those who did not recover from their depression after treatment (n = 29), cluster I trait scores were in fact higher than those measured at baseline, but there were no differences in categorical diagnoses before and after treatment. Cluster II personality traits and categorical diagnoses were not different between those who did and did not recover from their depression. Thus, depression may have a significant effect on the assessment of cluster I and cluster III personality traits. It is possible that cluster I and III 'personality traits' may be interwoven with depressive features and therefore subject to state influences, whereas cluster II personality traits may entail enduring, long-term characteristic modes of thinking, feeling, and behaving.
我们研究了急性抑郁症状是否以及如何影响适应不良人格特质的自我报告。68名急性抑郁症患者在药物治疗前后接受了《精神疾病诊断与统计手册》第三版人格障碍结构化访谈（SIDP），这使我们能够确定在抑郁期间和临床成功康复后，自我报告的适应不良人格特质是否存在差异。在首次进行SIDP访谈时（重度抑郁发作期间），患者在再次进行SIDP访谈前的4 - 5周内接受了去甲丙咪嗪治疗（剂量范围为150 - 300毫克/天）。对于那些从抑郁症中康复的患者（n = 39），第三类特质得分显著低于基线评估得分，且治疗后人格障碍的第三类分类诊断频率低于治疗前。与基线评分相比，康复患者治疗后的第一类人格特质得分也显著降低。对于那些治疗后未从抑郁症中康复的患者（n = 29），第一类特质得分实际上高于基线测量得分，但治疗前后的分类诊断没有差异。在从抑郁症中康复和未康复的患者之间，第二类人格特质和分类诊断没有差异。因此，抑郁症可能对第一类和第三类人格特质的评估有显著影响。第一类和第三类“人格特质”可能与抑郁特征相互交织，因此受状态影响，而第二类人格特质可能需要持久、长期的特征性思维、情感和行为模式。
