临床实践中轴II在诊断人格病理学方面的局限性。
Limitations of axis II in diagnosing personality pathology in clinical practice.
作者信息
Westen D, Arkowitz-Westen L
机构信息
Department of Psychiatry, Harvard Medical School and the Cambridge Hospital/Cambridge Health Alliance, MA 02139, USA.
出版信息
Am J Psychiatry. 1998 Dec;155(12):1767-71. doi: 10.1176/ajp.155.12.1767.
OBJECTIVE
DSM-IV's axis II is limited to severe personality disturbances, posing difficulty for diagnosing less severe but nonetheless clinically significant personality pathology. The authors examined the percentage of patients treated in clinical practice for personality pathology who are diagnosable with DSM-IV.
METHOD
Psychiatrists and psychologists from a random national sample provided diagnostic data on 714 patients treated for enduring, maladaptive personality patterns.
RESULTS
Only 39.4% of the patients had diagnosable axis II disorders. This percentage was relatively stable across clinicians' theoretical orientations and did not vary substantially when axis I diagnosis was controlled for.
CONCLUSIONS
DSM-IV cannot be used to diagnose most patients being treated for personality problems. The range of axis II should be broadened to encompass the range of personality pathology seen in clinical practice.
目的
《精神疾病诊断与统计手册》第四版（DSM-IV）的轴II仅限于严重的人格障碍，这给诊断不太严重但仍具有临床意义的人格病理学带来了困难。作者研究了在临床实践中接受人格病理学治疗的患者中可根据DSM-IV进行诊断的比例。
方法
来自全国随机样本的精神科医生和心理学家提供了714例因持久的适应不良人格模式而接受治疗的患者的诊断数据。
结果
只有39.4%的患者患有可诊断的轴II障碍。这一比例在临床医生的理论取向中相对稳定，在控制轴I诊断时也没有显著变化。
结论
DSM-IV不能用于诊断大多数因人格问题接受治疗的患者。轴II的范围应扩大，以涵盖临床实践中所见的人格病理学范围。
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