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边缘型人格障碍患者的攻击性、自杀行为和精神共病的性别差异和相似性。

Gender differences and similarities in aggression, suicidal behaviour, and psychiatric comorbidity in borderline personality disorder.

机构信息

James J. Peters Veterans' Administration Medical Center, Bronx, New York, USA.

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

出版信息

Acta Psychiatr Scand. 2019 Feb;139(2):145-153. doi: 10.1111/acps.12981. Epub 2018 Nov 12.

Abstract

OBJECTIVE

We examined gender differences and similarities in aggression, impulsivity, suicidal behaviour, and psychiatric comorbidity in men and women with borderline personality disorder (BPD) compared with healthy controls.

METHOD

A community sample of 511 participants (healthy controls: 81 men and 82 women; BPD patients: 145 men and 203 women) were rigorously characterized using structured diagnostic interviews and symptom severity assessments.

RESULTS

In comparison with women with BPD, men were less educated, had higher total Barratt Impulsivity Scale (BIS), BIS-motoric impulsiveness and BIS-non-planning impulsiveness subscale, total Buss-Perry Aggression Questionnaire (BPAQ), and BPAQ-physical aggression subscale scores. Men with BPD were more likely to have comorbid narcissistic, antisocial, paranoid, and schizotypal personality disorders, alcohol and substance use disorders but less likely to have dependent and obsessive-compulsive personality disorders compared to women with BPD. There was a trend toward higher maximum lethality of suicide attempts in men suicide attempters compared with women suicide attempters but no difference between men and women with regard to the proportion of suicide attempters or the number of suicide attempts.

CONCLUSION

Men with BPD are more impaired and may be at higher risk of dying by suicide compared to women with BPD.

摘要

目的

我们研究了边缘型人格障碍(BPD)患者中男性和女性与健康对照组相比在攻击性、冲动性、自杀行为和精神共病方面的性别差异和相似性。

方法

采用严格的结构诊断访谈和症状严重程度评估,对 511 名参与者(健康对照组:81 名男性和 82 名女性;BPD 患者:145 名男性和 203 名女性)进行了社区样本研究。

结果

与女性 BPD 患者相比,男性受教育程度较低,Barratt 冲动量表(BIS)总分、BIS-运动冲动性和 BIS-非计划性冲动性分量表、Buss-Perry 攻击问卷(BPAQ)总分和 BPAQ-身体攻击分量表得分较高。与女性 BPD 患者相比,男性 BPD 患者更可能同时患有自恋型、反社会型、偏执型和分裂样人格障碍、酒精和物质使用障碍,但更不可能同时患有依赖性和强迫症人格障碍。男性自杀未遂者的自杀企图最大致死率呈上升趋势,但男性和女性自杀未遂者在自杀企图的比例或自杀企图的次数方面没有差异。

结论

与女性 BPD 患者相比,男性 BPD 患者的受损程度更高,可能面临更高的自杀风险。

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