Escande M, Belazouz D, Girard M, Granier F, Charlet J P
Service de Psychiatrie d'Adulte, CHU Purpan-Casselardit, Toulouse.
Encephale. 1993 Jan-Feb;19(1):1-9.
The personality abnormalities observed during unipolar and bipolar manic-depressive disorders are known for years by german psychiatry as depressive temperament. In USA many works based on DSM III criteria have studied personality abnormalities coexisting with depression. The most frequently abnormalities are dependent, avoidant, compulsive, border line personality, observed with a frequency of 48% (P.A. Pilkonis) to 74% of patients (T.M. Shea et al.). But the personality traits or disorders are not the disorders only observed during remissions and intercrisis. Our personal work have studied the other disorders. This work concern pre-morbid period and intercrisis of 95 manic-depressed patients (45 unipolar and 50 bipolar patients). The time of remission is at least three months. Remission is certified by maximum scores of 10 on MADRS, 12 on Bech-Rafaelsen scale. The study of personality traits and other mental disorders is based on DSM III-R criteria. It is completed by Hamilton-Anxiety-Scale, Eysenck Personality Inventory and Beth-Israel Questionnaire of Sifneos. This study shows the following results. In pre-morbid period, the anxiety disorders are statistically more frequent in unipolar patients: generalized anxiety (35%), panic disorder (27%), psychosomatic disorders (30.5%). During intercrisis, the anxiety disorders are statistically more frequent in unipolar patients: generalized anxiety (51.1%), agoraphobia (31.1%) obsessive disorders (26.6%), panic disorder (18.2%). But this co-morbidity with anxious disorders is highly correlated with the incomplete characteristic of remission. During remission the personality abnormalities are similar to american studies, more frequent in unipolar patients, particularly obsessive personality (22.2 to 4%).(ABSTRACT TRUNCATED AT 250 WORDS)
多年来,德国精神病学一直将单相和双相躁郁症中观察到的人格异常称为抑郁气质。在美国,许多基于《精神疾病诊断与统计手册》第三版标准的研究探讨了与抑郁症共存的人格异常。最常见的异常包括依赖型、回避型、强迫型、边缘型人格,出现频率为48%(P.A. 皮尔科尼斯)至74%的患者(T.M. 谢伊等人)。但人格特质或障碍并非仅在缓解期和发作间期才被观察到。我们个人的研究关注了其他障碍。这项研究涉及95名躁郁症患者(45名单相患者和50名双相患者)的病前阶段和发作间期。缓解期至少为三个月。通过抑郁自评量表(MADRS)最高得分为10分、贝克-拉范森躁狂量表(Bech-Rafaelsen scale)最高得分为12分来确认缓解。基于《精神疾病诊断与统计手册》第三版修订版(DSM III-R)标准对人格特质和其他精神障碍进行研究。汉密尔顿焦虑量表、艾森克人格问卷和西夫neos的贝斯以色列问卷对研究进行了补充。该研究得出以下结果。在病前阶段,单相患者中焦虑障碍在统计学上更为常见:广泛性焦虑(35%)、惊恐障碍(27%)、心身障碍(30.5%)。在发作间期,单相患者中焦虑障碍在统计学上更为常见:广泛性焦虑(51.1%)、广场恐惧症(31.1%)、强迫症(26.6%)、惊恐障碍(18.2%)。但这种与焦虑障碍的共病与缓解的不完全特征高度相关。在缓解期,人格异常与美国的研究相似,在单相患者中更为常见,尤其是强迫型人格(22.2%至4%)。(摘要截选至250字)