Salı, Aralık 29, 2009

Borderline KB ve Disosiyatif bozukluk

Vedat Sar'in Journal of Clinical Psychiatry'de yayinlanan asagidaki calismasi ilginc.

Disosiyatif ozellikler DSM'ye gore Borderline kisilik bozuklugunun kriterlerinden kabul edilse de, bunun disosiyatif bir bozukluk haline donusmesi borderline hastalarin % 72'sinde goruluyor.

J Clin Psychiatry. 2006 Oct;67(10):1583- 90.

Axis I dissociative disorder comorbidity in borderline personality disorder and reports of childhood trauma.
Sar V, Akyuz G, Kugu N, Ozturk E, Ertem-Vehid H.

Department of Psychiatry, Clinical Psychotherapy Unit and Dissociative Disorders Program, Medical Faculty of Istanbul, Turkey. vsar@istanbul.

OBJECTIVE: The purpose of this study was to examine the dissociative disorder comorbidity of borderline personality disorder and its relation to childhood trauma reports in a nonclinical population.

METHOD: In April 2003, 1301 college students were screened for borderline personality disorder using the Structured Clinical Interview for DSM-IV Personality Disorders. The Childhood Trauma Questionnaire and Steinberg's dissociation questionnaires were also administered. During May and June 2003, 80 students with a diagnosis of borderline personality disorder and 111 nonborderline students were evaluated using the Structured Clinical Interview for DSM-IV Dissociative Disorders by an interviewer blind to the diagnosis and scores obtained during the first phase.

RESULTS: The prevalence of borderline personality disorder was 8.5%. A significant majority (72.5%; 58/80) of the borderline personality disorder group had a dissociative disorder, whereas this rate was only 18.0% (20/111) for the comparison group (p < .001). Childhood emotional and sexual abuse, physical neglect, and total childhood trauma scores had significant effect for borderline personality disorder (p < .001, p = .038, p = .044, and p = .003, respectively) , whereas emotional neglect and diminished minimization of childhood trauma had significant effect for dissociative disorder (p = .020 and p = .007, respectively) .

CONCLUSION: A significant proportion of subjects with borderline personality disorder have a comorbid dissociative disorder. Lack of interaction between dissociative disorder and borderline personality disorder diagnoses for any type of childhood trauma contradicts the opinion that both disorders together might be a single disorder. Recognizing highly prevalent but usually neglected Axis I dissociative disorder comorbidity in patients with borderline personality disorder may contribute to conceptual clarification of this spectrum of psychopathology

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