Borderline Personality Disorder and Unipolar Affective Disorder Long‐Term Effects of Comorbidity
Borderline Personality Disorder and Unipolar Affective Disorder Long‐Term Effects of Comorbidity
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边缘性人格障碍和单相情感障碍共病的长期影响
DOI：
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发表时间：
1987
影响因子：
1.9
通讯作者：
T. McGlashan
中科院分区：
文献类型：
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作者：
T. McGlashan
本研究追踪了Chestnut Lodge随访研究中主要由DSM-III定义的三组患者的基线临床表现和长期病程（平均15年）：单相情感障碍（UNI，N = 22），边缘型人格障碍（BPD，N = 55）和共病队列（UNI/BPD，N = 21）。BPD对UNI的共病影响包括基线时较早发作和无精神病症状，随访时更多药物滥用和使用精神病治疗。UNI对BPD的共病效应包括更好的病前工具功能，基线时发病较晚，长期自杀风险较高。其他值得注意的发现是，非共病BPD患者的自杀率较低（2%），非共病UNI患者的诊断不稳定率较高（68%）。研究结果表明，缺乏综合征的稳定性内和所有三个研究组之间，并强调了DSM-III的缺点，为调查合并症。
This study tracks the baseline clinical presentation and long-term course (average 15 years) of three patient groups defined largely by DSM-III from the Chestnut Lodge followup study: unipolar affective disorder (UNI, N = 22), borderline personality disorder (BPD, N = 55), and a comorbid cohort (UNI/BPD, N = 21). Comorbid BPD effects on UNI include earlier onset and absence of psychotic symptoms at baseline and more substance abuse and use of psychiatric treatment at follow-up. Comorbid UNI effects on BPD include better premorbid instrumental functioning, later onset at baseline, and a higher risk for suicide over the long term. Other noteworthy findings are a low rate of suicide (2%) among the noncomorbid BPD patients and a high rate of diagnostic instability (68%) among the noncomorbid UNI patients. Findings demonstrate a lack of syndromal stability within and among all three study groups and highlight the shortcomings of DSM-III for the investigation of comorbidity.