强迫障碍患者共病人格障碍.docVIP

强迫障碍患者共病人格障碍【摘 要】 目的：探讨强迫障碍（obsessive-compulsive disorder,OCD）患者共病轴Ⅱ人格障碍的情况。方法：对44例符合美国精神障碍诊断统计手册4版（Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition,DSM-IV）中OCD临床诊断标准的门诊和住院部患者，应用人格障碍诊断问卷4版（Personality Diagnostic Questionnaire,PDQ＋4）进行筛查。对筛查阳性者再用个性障碍晤谈手册（Personality Disorder Interview,PDI-IV）做半定式查询确定其中的人格障碍患者。结果：36名患者PDQ＋4筛查阳性，阳性率为82％。36名阳性患者中有32名OCD患者同时符合人格障碍的诊断标准，共病率为73%(32/44)，其中57%（25/44）的被试符合两种或两种以上人格障碍的诊断标准。共病率最高的3种人格障碍为C组的强迫型（64%）、回避型（57%）和A组的偏执型（21%）。结论：强迫障碍有较高的人格障碍共病率，其中共病率最高的为C组的强迫型和回避型。 【关键词】 强迫障碍；共病；人格障碍；横断面研究 中图分类号：R749.79,R749.91 文献标识码：A 文章编号：1000-6729(2011）002-0098-04 doi:10.3969/j.issn.1000-6729.2011.02.省略 【Abstract】 Objective:To investigate the comorbidity of obsessive-compulsive disorder(OCD)with Axis II personality disorders(PD).Methods：Forty-four patients who met the DSM-IV(Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition)criteria for OCD were screened with the Personality Diagnostic Questionnaire(PDQ＋4).And the PD positive subjects were assessed and diagnosed with the Personality Disorder Interview(PDI-IV).Results：Thirty-six of the 44 patients showed positive results in the PDQ＋4 screening,with the positive rate of 82%.Thirty-two of 44(73%)OCD patients also met DSM-IV criteria for Axis II personality disorders.Twenty-five of 44(57%)OCD patients were diagnosed with two or more kinds of Axis II disorders.The most common three personality disorders were obsessive compulsive(64%),avoidant(57%),and paranoid(21%).No subjects were diagnosed with antisocial and schizoid.Conclusion：Comorbidity of obsessive-compulsive disorder with personality disorders occurs pervasively.Patients with OCD are often diagnosed with Axis II personality disorders with the exception of antisocial and schizoid,especially with obsessive compulsive and avoidant of cluster-C. 【Key words】 obsessive-compulsive disorder;comorbidity;personality disorder;cross-sectional studies 1980年美国精神科学会的精神障碍诊断统计手册第3版(Diagnostic and Statist