Personality disorders in treatment-seeking combat veterans with posttraumatic stress disorder.
Personality disorders in treatment-seeking combat veterans with posttraumatic stress disorder.
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患有创伤后应激障碍寻求治疗的退伍军人的人格障碍。
DOI：
10.1176/ajp.150.7.1020
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
GillerJr,EL
中科院分区：
文献类型：
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作者：
Southwick,SM;Yehuda,R;GillerJr,EL
目的许多创伤后应激障碍（PTSD）患者似乎同时出现性格病理学症状；然而，迄今为止，还没有针对患有慢性 PTSD 的退伍军人的共病临床医生评定的轴 II 人格障碍进行实证研究。作者的目的是评估寻求治疗的患有 PTSD 的退伍军人的 DSM-III-R 人格障碍。方法他们使用人格障碍检查（针对 DSM-III-R 轴 II 障碍的标准化诊断访谈）来评估 34 名 PTSD 患者的 DSM-III-R 人格障碍；其中18名受试者为住院患者，16名为门诊患者。结果住院组和门诊组均观察到较高的性格病理率。最常见的符合标准的疾病是边缘型人格障碍、强迫型人格障碍、回避型人格障碍和偏执型人格障碍。住院患者几乎所有人格障碍的发病率都高于门诊患者。住院患者明显更有可能符合偏执型、分裂型、回避型和自毁型人格障碍的诊断标准。 结论 在寻求治疗的越战退伍军人中，与战争相关的创伤后应激障碍 (PTSD) 往往伴有弥漫性、衰弱性和持久性的性格缺陷。根据特定的轴 II 概况对 PTSD 患者进行亚型分类可能有助于选择更具体和有效的治疗方法。
ObjectiveMany patients with posttraumatic stress disorder (PTSD) appear to have co-occurring symptoms of character pathology; however, to date there have been no empirical studies of comorbid clinician-rated axis II personality disorders in war veterans with chronic PTSD. The authors' objective was to assess DSM-III-R personality disorders in treatment-seeking combat veterans with PTSD.MethodThey used the Personality Disorder Examination, a standardized diagnostic interview for DSM-III-R axis II disorders, to assess DSM-III-R personality disorders in 34 patients with PTSD; 18 of the subjects were inpatients and 16 were outpatients.ResultsA high rate of character pathology was observed in both inpatient and outpatient groups. The most frequent disorders for which criteria were met were borderline, obsessive-compulsive, avoidant, and paranoid personality disorders. Inpatients had a higher rate of nearly every personality disorder than did outpatients. Inpatients were significantly more likely to meet diagnostic criteria for paranoid, schizotypal, avoidant, and self-defeating personality disorders.ConclusionsWar-related PTSD in treatment-seeking Vietnam veterans is often accompanied by diffuse, debilitating, and enduring impairments in character. Subtyping patients with PTSD on the basis of specific axis II profiles may aid in the selection of more specific and effective treatments.