Hardy G E, Barkham M, Shapiro D A, Stiles W B, Rees A, Reynolds S
Medical Research Council-Economic and Social Research Council (MRC/ESRC) Social and Applied Psychology Unit, University of Sheffield, United Kingdom.
J Consult Clin Psychol. 1995 Dec;63(6):997-1004. doi: 10.1037//0022-006x.63.6.997.
Twenty-seven of 114 depressed clients, stratified for severity of depression, obtained a Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; DSM-III; American Psychiatric Association, 1980) diagnosis of Cluster C personality disorder--that is, avoidant, obsessive-compulsive or dependent personality disorder (PD clients)--whereas the remaining 87 did not (non-personality-disorder [NPD] clients). All clients completed either 8 or 16 sessions of cognitive-behavioral (CB) or psychodynamic-interpersonal (PI) psychotherapy. On most measures, PD clients began with more severe symptomatology than NPD clients. Among those who received PI therapy, PD clients maintained this difference posttreatment and at 1-year follow-up. Among those who received CB therapy, posttreatment differences between PD and NPD groups were not significant. Treatment length did not influence outcome for PD clients. PD clients whose depression was also relatively severe showed significantly less improvement after treatment than either PD clients with less severe depression or NPD clients.
114名根据抑郁严重程度分层的抑郁患者中,有27名被诊断为《精神疾病诊断与统计手册》(第3版;DSM-III;美国精神病学协会,1980)中的C类人格障碍,即回避型、强迫型或依赖型人格障碍(人格障碍患者),而其余87名则未被诊断为该类人格障碍(非人格障碍患者)。所有患者均完成了8次或16次认知行为(CB)或心理动力人际(PI)心理治疗。在大多数测量指标上,人格障碍患者开始时的症状比非人格障碍患者更严重。在接受PI治疗的患者中,人格障碍患者在治疗后和1年随访时仍保持这种差异。在接受CB治疗的患者中,人格障碍组和非人格障碍组在治疗后的差异不显著。治疗时长对人格障碍患者的治疗效果没有影响。抑郁程度也相对严重的人格障碍患者在治疗后的改善明显少于抑郁程度较轻的人格障碍患者或非人格障碍患者。