Ten-year course of borderline personality disorder: psychopathology and function from the Collaborative Longitudinal Personality Disorders study.
Ten-year course of borderline personality disorder: psychopathology and function from the Collaborative Longitudinal Personality Disorders study.
复制标题
DOI：
10.1001/archgenpsychiatry.2011.37
复制
发表时间：
2011-08
影响因子：
--
通讯作者：
Skodol, Andrew E.
中科院分区：
文献类型：
--
作者：
Gunderson, John G.;Stout, Robert L.;McGlashan, Thomas H.;Shea, Tracie;Morey, Leslie C.;Grilo, Carlos M.;Zanarini, Mary C.;Yen, Shirley;Markowitz, John C.;Sanislow, Charles;Ansell, Emily;Pinto, Anthony;Skodol, Andrew E.
边缘型人格障碍（BPD）传统上被认为是慢性和顽固性的。比较10年以上BPD与其他人格障碍及重性抑郁障碍（MDD）的精神病理及社会功能的病程。一项对寻求治疗的18至45岁患者进行的合作研究，采用标准化，可靠和重复的诊断缓解和复发以及整体社会功能和社会功能亚型的测量进行随访。美国东北部4个城市的19个临床环境（医院和门诊）。三个研究组，包括175例BPD患者，312例C群人格障碍患者，95例MDD但无人格障碍患者。使用DSM-IV人格障碍诊断访谈及其后续沿着版本（DSM-IV人格障碍诊断访谈-后续沿着版本）诊断人格障碍并评估其变化。使用DSM-IV轴I障碍的结构化临床访谈和纵向间隔随访评估来诊断MDD并评估MDD和社会功能的变化。85%的BPD患者缓解。BPD的缓解比MDD慢（P<0.001），比其他人格障碍慢（P<0.03）。12%的BPD患者复发，复发率低于MDD（P<0.001）和其他人格障碍（P= 0.008）患者。所有BPD标准均以相似的速率下降。社会功能评分显示严重的损害，只有适度的，但统计学显着改善; BPD患者仍然比其他两组持续更多的功能障碍（P<0.001）。标准的降低预示着随后的DSM-IV轴V总体功能评估评分的改善（P<0.001）。BPD的10年病程的特点是高缓解率，低复发率，以及严重和持续的社会功能障碍。这些结果告知患者，家庭和临床医生的期望，并记录了这种疾病的严重公共卫生负担。
Borderline personality disorder (BPD) is traditionally considered chronic and intractable. To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. A collaborative study of treatment-seeking, 18-to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning. Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities. Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 with MDD but no personality disorder. The Diagnostic Interview for DSM-IV Personality Disorders and its follow-along version (the Diagnostic Interview for DSM-IV Personality Disorders–Follow-Along Version) were used to diagnose personality disorders and assess changes in them. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Longitudinal Interval Follow-up Evaluation were used to diagnose MDD and assess changes in MDD and in social function. Eighty-five percent of patients with BPD remitted. Remission of BPD was slower than for MDD (P<.001) and minimally slower than for other personality disorders (P<.03). Twelve percent of patients with BPD relapsed, a rate less frequent and slower than for patients with MDD (P<.001) and other personality disorders (P=.008). All BPD criteria declined at similar rates. Social function scores showed severe impairment with only modest albeit statistically significant improvement; patients with BPD remained persistently more dysfunctional than the other 2 groups (P<.001). Reductions in criteria predicted subsequent improvements in DSM-IV Axis V Global Assessment of Functioning scores (P<.001). The 10-year course of BPD is characterized by high rates of remission, low rates of relapse, and severe and persistent impairment in social functioning. These results inform expectations of patients, families, and clinicians and document the severe public health burden of this disorder.
登录
查看更多内容
影响因子：
2.3
作者：
Davidson K;Norrie J;Tyrer P;Gumley A;Tata P;Murray H;Palmer S
通讯作者：
Palmer S
DOI：
10.1176/appi.ajp.2009.08121825
发表时间：
2009-05
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Gunderson JG
通讯作者：
Gunderson JG
影响因子：
2.3
作者：
Gunderson, John G.
通讯作者：
Gunderson, John G.
影响因子：
1.9
作者：
KELLER, MB;LAVORI, PW;MUELLER, TI
通讯作者：
MUELLER, TI
影响因子：
2.3
作者：
Gunderson, JG;Shea, MT;Keller, MB
通讯作者：
Keller, MB