Fabrega H, Ulrich R, Pilkonis P, Mezzich J
University of Pittsburgh School of Medicine, PA.
Hosp Community Psychiatry. 1993 Feb;44(2):159-62. doi: 10.1176/ps.44.2.159.
The purpose of the study was to determine the prevalence of personality disorders among a large population of persons seeking treatment in a public psychiatric facility and to examine the role of personality disorders in the clinical conditions of persons frequenting such facilities.
Clinical and demographic data were retrospectively examined for 18,179 adults who visited a walk-in clinic of a public psychiatric facility between 1983 and 1989. Patients who received a diagnosis of personality disorder were compared with those who did not.
A total of 2,344 patients (12.9 percent) were diagnosed as having a personality disorder, a lower prevalence rate than generally found in treatment populations. The most frequent diagnoses were atypical, antisocial, and borderline personality disorders. Compared with other subjects, those with a personality disorder were significantly more likely to be men, to be 35 years old or younger, to have a higher level of social impairment, and to have more symptoms and more severe symptoms.
The relatively low prevalence rate was attributed in part to underdiagnosis, largely due to the need for making rapid assessments in a public intake setting. The authors conclude that clinicians in such facilities may be likely to diagnose personality disorders when patients with certain axis I disorders such as substance use, affective, and adjustment disorders present with an overall greater level of symptomatology and social impairment.
本研究旨在确定在一家公立精神病治疗机构寻求治疗的大量人群中人格障碍的患病率，并探讨人格障碍在常去此类机构的患者临床状况中的作用。
对1983年至1989年间前往一家公立精神病治疗机构的随诊门诊就诊的18179名成年人的临床和人口统计学数据进行回顾性检查。将被诊断为人格障碍的患者与未被诊断为人格障碍的患者进行比较。
共有2344名患者（12.9%）被诊断为人格障碍，患病率低于治疗人群中的一般水平。最常见的诊断是非典型、反社会和边缘型人格障碍。与其他受试者相比，患有人格障碍的患者更有可能是男性，年龄在35岁及以下，社会损害程度更高，症状更多且更严重。
相对较低的患病率部分归因于诊断不足，这主要是由于在公立机构入院时需要进行快速评估。作者得出结论，当患有某些轴I障碍（如物质使用障碍、情感障碍和适应障碍）的患者出现总体症状和社会损害程度更高的情况时，此类机构的临床医生可能更容易诊断人格障碍。
