境界性人格障害を合併した摂食障害患者の心理社会的発症要因と長期予後 : 強迫性人格傾向をもつ摂食障害患者との比較

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Psychosocial factors and clinical symptoms as well as long-term outcome in patients with eating disorder complicated with borderline personality disorder (BPD Group) were investigated and compared with those in patients with obsessive-compulsive personality trait (Obsessive-Compulsive Personality Group). The subjects were four males and 32 females with the mean age of 18.2 years who had been referred to the Neuropsychiatric Clinic of Fukushima Medical College Hospital and affiliated hospitals. The diagonses of borderline personality disorder, obsessive-compulsive personality trait, and eating disorders ware made according to DSM-III-R diagnostic criteria. Fifteen patients were diagnosed as having borderline personality disorder and 21 as having obsessive-compulsive personality trait. Among the psychosocial factors evaluated (precipitating factors, psychosocial stressors, and serious family pathology), extended parental absence was more common in the BPD Group than in the Obsessive-Compulsive Personality Group. Concerning the clinical symptoms (mental symptoms, behavioral disorders, and somatic symptoms), depressive mood, suicide attempts, and self-mutilating behaviors were more common in the BPD Group. Long-term outcome (more than five years after the onset) was evaluated in 11 patients in the BPD Group (mean duration, 8.5 years) and in 10 patients in the Obsessive-Compulsive Personality Group (mean duration, 7.6 years). In the BPD Group, long-term outcome for both eating behavior and mental symptoms was unfavorable, and was distinctly poorer than that for the Obsessive-Compulsive Personality Group. These results suggest that patients with borderline peresonality disorder are therapyresistant, that outcome is more likely to be unfavorable in this group than in patients with obsessive-compulsive personality, and that it may be necessary for such patients to receive more intensive treatment, including family therapy.
日本心身医学会の論文
1992-08-01

境界性人格障害を合併した摂食障害患者の心理社会的発症要因と長期予後 : 強迫性人格傾向をもつ摂食障害患者との比較

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