Coccaro E F
Department of Psychiatry, MCP Hahnemann School of Medicine, Philadelphia, PA 19129, USA.
J Clin Psychiatry. 1998;59 Suppl 1:30-5; discussion 36-7.
This paper reviews the biological and psychopharmacologic nature of personality disordered subjects, specifically those with borderline (BPD) and schizotypal (ScPD) personality disorder. Generally speaking, there is no agent of choice for the treatment of either BPD or ScPD. Many agents of different classes appear to offer some benefit to selected subjects depending upon their symptom presentation. For example, ScPD or BPD subjects with prominent cognitive/perceptual distortion may respond to neuroleptic agents, while some BPD subjects with depressed mood may respond best to antidepressants. The hypothesis that biological and behavioral dimensions underlie the psychopharmacologic response to treatment in personality disordered subjects, proposed over the past decade, is now being tested. The most salient example of this is the testing of serotonin-specific agents (e.g., fluoxetine) for potential antiaggressive efficacy in personality disordered subjects with prominent histories of impulsive aggressive behavior and putative reduced serotonin system function.
本文综述了人格障碍患者，特别是边缘型人格障碍（BPD）和分裂型人格障碍（ScPD）患者的生物学和心理药理学特性。一般来说，治疗BPD或ScPD没有首选药物。许多不同种类的药物似乎能根据特定患者的症状表现为其带来一定益处。例如，存在明显认知/感知扭曲的ScPD或BPD患者可能对抗精神病药物有反应，而一些情绪低落的BPD患者可能对抗抑郁药物反应最佳。过去十年提出的关于生物学和行为维度是人格障碍患者药物治疗反应基础的假说，目前正在接受检验。最突出的例子是，针对有明显冲动攻击行为史且假定5-羟色胺系统功能降低的人格障碍患者，测试5-羟色胺特异性药物（如氟西汀）的潜在抗攻击疗效。
