Parker G, Roussos J, Austin M P, Hadzi-Pavlovic D, Wilhelm K, Mitchell P
Prince Henry Hospital and the School of Psychiatry, University of New South Wales, Sydney, Australia.
J Affect Disord. 1998 Jan;47(1-3):131-40. doi: 10.1016/s0165-0327(97)00133-x.
We test whether there is differential representation of disordered personality function across melancholic and non-melancholic depressive sub-types, with levels of differentiation examined against differing sub-typing measures.
In a sample of 245 subjects meeting criteria for a non-psychotic major depressive episode lasting less than 2 years, we examine for differential rates of disordered personality style across melancholic and non-melancholic depression, using four differing sub-typing measures (i.e., DSM-III-R and DSM-IV criteria, Newcastle Index, and the CORE measure). Disordered personality was assessed by psychiatrist ratings of 15 differing personality styles underpinning disorder classes, and several parameters and domains that reflect the arenas whereby disordered personality may be manifested.
However defined, those with non-melancholic depression were distinctly more likely to rate as showing disordered personality function, with over-representation to an avoidant personality disorder style being the most consistently and strongly identified personality disorder class. Because of limitations to several of the sub-typing measures, we focus on the DSM-IV system. Discriminant function analyses indicated that those so identified as having non-melancholic depression were significantly more likely to rate as having avoidant and schizoid personality styles. A principal components analysis of our 15 differing personality disorder classes identified three molar classes corresponding to the three-cluster DSM system. Again, non-melancholic (compared to melancholic) subjects were more likely to return higher scores: in order, an 'anxious and fearful' (Cluster C) personality style, then an 'eccentric' Cluster A, and somewhat less clearly, a 'dramatic' Cluster B personality disorder style. Specificity to the non-melancholic depressive class was again suggested in relation to a large number of the parameters and domains measuring disordered personality function.
Disordered personality function appears distinctly more likely in non-melancholic, compared to melancholic depression.
我们检验在抑郁性和非抑郁性抑郁亚型中，人格功能障碍的表现是否存在差异，并针对不同的亚型分类方法来考察差异程度。
在一个由245名符合非精神病性重度抑郁发作标准且病程少于2年的受试者组成的样本中，我们使用四种不同的亚型分类方法（即DSM-III-R和DSM-IV标准、纽卡斯尔指数以及CORE测量法），考察抑郁性和非抑郁性抑郁中人格风格障碍的发生率差异。人格障碍通过精神科医生对构成障碍类别的15种不同人格风格以及若干反映人格障碍可能表现领域的参数和维度进行评定。
无论如何定义，非抑郁性抑郁患者明显更有可能被评定为人格功能障碍，其中过度表现为回避型人格障碍风格是最一致且最强烈被认定的人格障碍类别。由于几种亚型分类方法存在局限性，我们重点关注DSM-IV系统。判别函数分析表明，那些被认定为患有非抑郁性抑郁的患者明显更有可能被评定为具有回避型和分裂样人格风格。对我们的15种不同人格障碍类别的主成分分析确定了与DSM三分类系统相对应的三个主要类别。同样，非抑郁性（与抑郁性相比）受试者更有可能得到更高的分数：依次为“焦虑和恐惧”（C类）人格风格，然后是“古怪”的A类，以及不太明显的“戏剧化”B类人格障碍风格。在大量测量人格功能障碍的参数和维度方面，再次表明了非抑郁性抑郁类别的特异性。
与抑郁性抑郁相比，人格功能障碍在非抑郁性抑郁中似乎明显更常见。
