Battaglia M, Przybeck T R, Bellodi L, Cloninger C R
Istituto Scientifico H San Raffaele, Department of Neuropsychiatric Sciences, University of Milano School of Medicine, Italy.
Compr Psychiatry. 1996 Jul-Aug;37(4):292-8. doi: 10.1016/s0010-440x(96)90008-5.
The comorbidity of DSM-III-R axis I and axis II disorders presents conceptual and nosological challenges to psychiatry. In a consecutive series of 164 psychiatric outpatients and 36 healthy controls in Milan, Italy, psychopathology was measured by structured interviews for DSM-III-R disorders and temperament was measured by the Tridimensional Personality Questionnaire (TPQ). Low reward dependence (RD) distinguished cluster A personality disorders and no axis I disorders. High novelty seeking (NS) characterized cluster B personality disorders and patients with eating disorders, alcohol abuse, or substance abuse. High harm avoidance (HA) characterized all cluster C personality disorders and patients with mood or anxiety disorders. The temperament dimensions were nearly independent of one another, but patients often had multiple DSM-III-R diagnoses. The joint relations of these disorders to multiple temperament dimensions accounted for their characteristic patterns of comorbidity. These findings support the hypothesis that interactions among temperament dimensions during development influence comorbidity between axis I and axis II disorders.
《精神疾病诊断与统计手册》第三版修订本（DSM - III - R）轴I与轴II障碍的共病现象给精神病学带来了概念和分类学上的挑战。在意大利米兰对164名连续就诊的精神科门诊患者和36名健康对照者进行的研究中，通过针对DSM - III - R障碍的结构化访谈来测量精神病理学，并通过三维人格问卷（TPQ）来测量气质。低奖赏依赖（RD）可区分A类人格障碍且无轴I障碍。高新奇寻求（NS）是B类人格障碍以及患有饮食失调、酒精滥用或物质滥用患者的特征。高回避伤害（HA）是所有C类人格障碍以及患有情绪或焦虑障碍患者的特征。气质维度彼此几乎相互独立，但患者常常有多种DSM - III - R诊断。这些障碍与多种气质维度的联合关系解释了它们共病的特征模式。这些发现支持了这样一种假设，即发育过程中气质维度之间的相互作用会影响轴I与轴II障碍之间的共病情况。
