The impact of comorbid dysthymic disorder on outcome in personality disorders.
The impact of comorbid dysthymic disorder on outcome in personality disorders.
复制标题
共病心境恶劣障碍对人格障碍结果的影响。
DOI：
10.1016/j.comppsych.2009.11.002
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发表时间：
2010
影响因子：
7.3
通讯作者：
McGlashan,ThomasH
中科院分区：
文献类型：
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作者：
Hellerstein,DavidJ;Skodol,AndrewE;Petkova,Eva;Xie,Hui;Markowitz,JohnC;Yen,Shirley;Gunderson,John;Grilo,Carlos;Daversa,MariaT;McGlashan,ThomasH
本研究的目的是探讨抑郁症（DD），一种慢性抑郁症，对人格障碍（PDs）的个体的自然结果的影响。方法纵向人格障碍协作研究是一个队列，最初包括573名受试者4个目标PD（边缘型，回避型，强迫型）和95名受试者与抑郁症，但没有PD。基线时，115例受试者被诊断为同时存在DD，其中109例（94.8%）为PD受试者。进行回归分析，以预测2年前瞻性随访后的3类广泛临床结局。我们假设基线时DD诊断与以下方面的不良结局相关：（1）PD诊断的持续性，（2）心理社会功能受损（通过纵向间隔随访评估测量），（3）危机相关治疗利用率。它与整体社会适应、生活满意度、娱乐和友谊的结果更差相关，但与就业或与配偶的关系无关。与预期相反，DD并没有增加自杀企图，急诊室就诊，或精神病hospitalizations.CONCLUSIONSComorrhage的DD是与持久性PD诊断和更糟糕的结果，对许多，但不是所有的，心理社会功能的措施。
OBJECTIVEThe goal of our study was to investigate the impact of dysthymic disorder (DD), a form of chronic depression, on naturalistic outcome in individuals with personality disorders (PDs).METHODThe Collaborative Longitudinal Personality Disorders Study is a cohort initially including 573 subjects with 4 targeted PDs (borderline, avoidant, schizotypal, and obsessive-compulsive) and 95 subjects with major depression but no PD. At baseline, 115 subjects were diagnosed with coexisting DD, of whom 109 (94.8%) were PD subjects. Regression analyses were performed to predict 3 classes of broad clinical outcome after 2 years of prospective follow-up. We hypothesized that DD diagnosis at baseline would be associated with worse outcome on (1) persistence of a PD diagnosis, (2) impairment in psychosocial functioning (as measured by the Longitudinal Interval Follow-up Evaluation), and (3) crisis-related treatment utilization.RESULTSBaseline DD diagnosis was associated with persistence of PD diagnosis at 2 years, particularly for borderline and avoidant PDs. It was associated with worse outcome on global social adjustment, life satisfaction, recreation, and friendships, but not employment or relationship with spouse. Contrary to expectation, DD did not increase suicide attempts, emergency room visits, or psychiatric hospitalizations.CONCLUSIONSComorbidity of DD is associated with persistence of PD diagnosis and with worse outcome on many, but not all, measures of psychosocial functioning.