Prediction of the 10-year course of borderline personality disorder.
Prediction of the 10-year course of borderline personality disorder.
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DOI：
10.1176/ajp.2006.163.5.827
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发表时间：
2006-05
期刊：
影响因子：
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通讯作者：
M. Zanarini;F. Frankenburg;J. Hennen;D. B. Reich;K. Silk
中科院分区：
文献类型：
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作者：
M. Zanarini;F. Frankenburg;J. Hennen;D. B. Reich;K. Silk
目的：本研究的目的是确定边缘型人格障碍患者缓解时间的最具临床相关性的基线预测因子。方法共290名符合修订的边缘性人格障碍诊断访谈和DSM-III-R边缘性人格障碍诊断标准的住院患者在其索引入院期间进行了评估，采用一系列半结构化访谈和自我报告措施。在5个连续的2年时间段内重新评估诊断状态。离散生存分析方法，控制边界精神病理学的基线严重程度和时间，用于估计风险比。结果88%的边缘型人格障碍患者获得缓解。在缓解时间方面，242例疾病缓解的患者中，39.3%在2年随访时首次缓解，另外22.3%在4年随访时首次缓解，另外21.9%在6年随访时缓解，另外12.8%在8年随访时缓解，另外3.7%在10年随访时缓解。16个变量被认为是早期缓解时间的显著双变量预测因子。其中7个在多变量分析中仍然显着：年龄较小，没有儿童期性虐待，没有物质使用障碍的家族史，良好的职业记录，没有焦虑的集群人格障碍，低神经质，高宜人性。结论：本研究的结果表明，预测缓解边缘型人格障碍的时间是多因素的性质，涉及的因素，在临床实践中的常规评估和因素，特别是气质方面，这不是。
OBJECTIVE The purpose of this study was to determine the most clinically relevant baseline predictors of time to remission for patients with borderline personality disorder. METHOD A total of 290 inpatients meeting criteria for both the Revised Diagnostic Interview for Borderlines and DSM-III-R for borderline personality disorder were assessed during their index admission with a series of semistructured interviews and self-report measures. Diagnostic status was reassessed at five contiguous 2-year time periods. Discrete survival analytic methods, which controlled for baseline severity of borderline psychopathology and time, were used to estimate hazard ratios. RESULTS Eighty-eight percent of the patients with borderline personality disorder studied achieved remission. In terms of time to remission, 39.3% of the 242 patients who experienced a remission of their disorder first remitted by their 2-year follow-up, an additional 22.3% first remitted by their 4-year follow-up, an additional 21.9% by their 6-year follow-up, an additional 12.8% by their 8-year follow-up, and another 3.7% by their 10-year follow-up. Sixteen variables were found to be significant bivariate predictors of earlier time to remission. Seven of these remained significant in multivariate analyses: younger age, absence of childhood sexual abuse, no family history of substance use disorder, good vocational record, absence of an anxious cluster personality disorder, low neuroticism, and high agreeableness. CONCLUSIONS The results of this study suggest that prediction of time to remission from borderline personality disorder is multifactorial in nature, involving factors that are routinely assessed in clinical practice and factors, particularly aspects of temperament, that are not.