Tyrer P, Seivewright N, Ferguson B, Murphy S, Johnson A L
St. Mary's Hospital Medical School, St Charles Hospital, London.
Br J Psychiatry. 1993 Feb;162:219-26. doi: 10.1192/bjp.162.2.219.
Repeated assessments of psychopathology, together with personality status, were made over two years on 181 psychiatric out-patients with generalised anxiety disorder (59), panic disorder (66), or dysthymic disorder (56) diagnosed using an interview schedule for DSM-III. Patients were randomly allocated to drug treatment, cognitive and behaviour therapy, or a self-help treatment programme. Although there were no overall differences in compliance rate and efficacy between the three modes of treatment, the psychological treatment methods, particularly self-help, were more effective in patients without personality disorder, and those with personality disorder responded better to drug treatment, primarily antidepressants. The findings suggest that assessment of personality status could be a valuable aid to selection of treatment in neurotic disorders and that self-help approaches are particularly valuable once personality disorder has been excluded.
对181名使用DSM-III访谈提纲诊断为广泛性焦虑症（59例）、惊恐障碍（66例）或心境恶劣障碍（56例）的精神科门诊患者，在两年多的时间里对其精神病理学以及人格状况进行了反复评估。患者被随机分配到药物治疗、认知行为疗法或自助治疗方案中。虽然三种治疗方式在依从率和疗效方面没有总体差异，但心理治疗方法，尤其是自助治疗，对无人格障碍的患者更有效，而有人格障碍的患者对药物治疗，主要是抗抑郁药物反应更好。研究结果表明，人格状况评估可能有助于神经症性障碍治疗方法的选择，而且一旦排除人格障碍，自助方法就特别有价值。
