背景:边缘性人格障碍(PD)的精神病谱系特征是一个长期存在的现象,但值得注意的是,到目前为止,它们并不是许多实证研究的焦点。此外,承认他们与情感性精神病有联系的比较研究甚至更少。同样,DSM-5维度方法的实证研究对这一主题的贡献也不常见。本研究旨在确定最佳的病理性人格特征和/或症状,这些特征和/或症状是边缘性PD和双相情感障碍中精神病特征(精神病和观念偏执症状)的预测因子。基于DSM-5第三节人格特质的框架。
方法:两个临床样本的横断面研究:1)63名参与者的边缘PD组;2)65名参与者的双相情感障碍组。自我报告评估:DSM-5人格量表(PID-5);简要症状量表(BSI)。计算了一系列线性和逻辑回归分析。
结果:总体而言,作为常见预测因子出现的数据是分离的,消极情感,精神病,抑制性,宏伟,可疑和人际关系敏感症状。边界PD在BSI偏执观念中得分最高,作为其区别特征出现(NagelkerkeR2=.58):认知和感知失调(OR:13.02),限制性情感(OR:12.09),撤回(OR:11.70),快感缺失(OR:10.98)和情绪不稳定(OR:6.69)。
结论:除了似乎与精神病超谱两种疾病重叠的共性外,作为精神病特征基础的病理性人格症状模式似乎加强了精神分裂症和双相情感障碍之间的位置,PD可能处于临界状态,强调其与分裂情感/精神病光谱相交的可能性。精神病特征的病态人格性质是现象学维度的潜在综合特征。
BACKGROUND: Psychotic spectrum features in borderline personality disorder (PD) are a long-standing phenomenon, but remarkably, to date, they have not been the focus of many empirical studies. Moreover, the comparative studies that acknowledge their links to affective psychoses are even more scarce. Likewise, the contributions of empirical research on the DSM-5 dimensional approach to this topic are also uncommon. This study seeks to identify the best set of pathological personality traits and/or symptoms that are predictors of psychotic features (psychoticism and ideation paranoid symptoms) in borderline PD and in bipolar disorder, based on the framework of the DSM-5 section III personality traits.
METHODS: A cross-sectional study of two clinical samples: 1) Borderline PD group of 63 participants; 2) Bipolar disorder group of 65 participants. Self-reported assessment: Personality Inventory for DSM-5 (PID-5); Brief Symptom Inventory (BSI). A series of linear and logistic regression analyses were computed.
RESULTS: Overall, the data emerging as common predictors are detachment, negative affectivity, psychoticism, depressivity, grandiosity, suspiciousness and interpersonal sensitivity symptoms. Borderline PD has the highest score in BSI paranoid ideation which emerges as its discriminating trait (Nagelkerke R2 = .58): cognitive and perceptual dysregulation (OR: 13.02), restricted affectivity (OR: 12.09), withdrawal (OR: 11.70), anhedonia (OR: 10.98) and emotional lability (OR: 6.69).
CONCLUSIONS: Besides the commonality that appears to overlap both disorders with a psychosis superspectrum, the patterns of the pathological personality-symptoms underlying the psychotic features appear to reinforce a position between schizophrenia and bipolar disorders that borderline PD may occupy, highlighting the possibility of its intersection with schizoaffective/psychosis spectra. The pathological personality nature of the psychotic features emerges as a potential comprehensive trait of the phenomenological dimensions.