Psychosocial functioning of borderline patients and axis II comparison subjects followed prospectively for six years
Psychosocial functioning of borderline patients and axis II comparison subjects followed prospectively for six years
复制标题
DOI：
10.1521/pedi.19.1.19.62178
复制
发表时间：
2005-02-01
影响因子：
2.3
通讯作者：
Silk, KR
中科院分区：
文献类型：
--
作者：
Zanarini, MC;Frankenburg, FR;Silk, KR
本研究的目的是通过6年的前瞻性随访，确定边缘型人格障碍（BPD）患者的心理社会功能的过程。290例符合DIB-R和DSM-III-R标准的BPD患者和72例符合DSM-III-R标准的另一种轴II障碍患者（两种标准均不适用于BPD）的心理社会功能在基线时使用经证实可靠性的半结构化访谈进行评估。超过94%的存活患者在三个不同的随访波（2年、4年和6年随访）对他们的心理社会功能进行了重新访谈，而对所有先前收集的信息一无所知。随着时间的推移，边缘患者的心理社会功能得到了大幅改善，满足良好的整体心理社会功能标准的百分比从基线时的26%增加到第三波随访期间的56%。尽管有这种改善，边缘患者的功能显着更差比轴II比较科目，特别是在该地区的职业成就。然而，一项更详细的检查显示，在研究过程中经历症状缓解的边缘患者在社会和职业方面的功能明显优于从未缓解的边缘患者。更具体地说，他们更有可能与配偶/伴侣和至少一位父母有良好的关系，良好的工作/学校表现，持续的工作/学校历史，GAF评分为61或更高（43%对0%，6年后，他们的指数入院），并有良好的整体心理社会功能（66%对27%，6年随访）。总之，这项研究的结果表明，心理社会改善是常见的边缘患者和强烈相关的症状状态。
The purpose of this study was to determine the course of the psychosocial functioning of patients with borderline personality disorder (BPD) over 6 years of prospective follow-up. The psychosocial functioning of 290 patients meeting both DIB-R and DSM-III-R criteria for BPD and 72 patients meeting DSM-III-R criteria for another Axis II disorder (and neither criteria set for BPD) was assessed at baseline using a semistructured interview of demonstrated reliability. Over 94% of surviving patients were reinterviewed about their psychosocial functioning blind to all previously collected information at three distinct follow-up waves: 2-, 4-, and 6-year follow-up. The psychosocial functioning of borderline patients improved substantially over time, with the percentage meeting criteria for good overall psychosocial functioning increasing from 26% at baseline to 56% during the third wave of follow-up. Despite this improvement, borderline patients functioned significantly more poorly than Axis II comparison subjects, particularly in the area of vocational achievement. However, a more detailed examination revealed that borderline patients who had experienced a symptomatic remission during the course of the study functioned significantly better both socially and vocationally than never-remitted borderline patients. More specifically, they were significantly more likely to have a good relationship with a spouse /partner and at least one parent, good work/school performance, a sustained work/school history, a GAF score of 61 or higher (43% vs. 0% 6 years after their index admission), and to have good overall psychosocial functioning (66% vs. 27% at 6 year follow-up). Taken together, the results of this study suggest that psychosocial improvement is both common among borderline patients and strongly related to their symptomatic status.