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人格障碍与临床障碍:共病自闭症谱系障碍(ASD)、进食障碍(EDs)、创伤后应激障碍(PTSD)或躯体症状障碍(SSD)的挑战。

Personality Disorders and Clinical Disorders: The Challenge of Comorbid Autism Spectrum Disorder (ASD), Eating Disorders (EDs), Posttraumatic Stress Disorder (PTSD), or Somatic Symptom Disorder (SSD).

作者信息

Links Paul S, Aslam Hira, O'Donnell McKenna

机构信息

Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, 688 Queensdale Avenue E., Hamilton, ON, L8V 1M1, Canada.

Department of Psychology, Neuroscience and Behaviour, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.

出版信息

Curr Psychiatry Rep. 2025 Jan;27(1):1-9. doi: 10.1007/s11920-024-01571-8. Epub 2024 Nov 28.

Abstract

PURPOSE OF THE REVIEW

The purpose of this review is to report on prevalence of co-occurrence, possible etiologic mechanisms, and course and treatment implications of each of these challenging clinical disorders (Autism Spectrum Disorder, Eating Disorders, Posttraumatic Stress Disorder) comorbid with Personality Disorders.

RECENT FINDINGS

These comorbidities often increase the symptom severity, worsen the course and outcome, and increase the risk of self-harm and suicidal behavior. For EDs and PTSD, existing therapies may prove somewhat helpful but novel approaches are needed and under investigation in the context of comorbid PDs and ASD, EDs and PTSD to address common underlying diatheses. Treatments for these comorbid disorders need to incorporate interventions addressing suicide risk, emotion dysregulation, be trauma-informed and attend to patient engagement. Future research should prioritize studying the course and outcome of ASD comorbid with PDs, novel therapies for EDs comorbid with PDs; refining the concept of Complex PTSD and commencing study of SSD comorbid with PDs.

摘要

综述目的

本综述旨在报告这些具有挑战性的临床疾病(自闭症谱系障碍、饮食失调症、创伤后应激障碍)与人格障碍共病的发生率、可能的病因机制以及病程和治疗意义。

最新发现

这些共病情况往往会加重症状严重程度、恶化病程和预后,并增加自我伤害和自杀行为的风险。对于饮食失调症和创伤后应激障碍,现有疗法可能有一定帮助,但在共病人格障碍、自闭症谱系障碍、饮食失调症和创伤后应激障碍的背景下,需要新的方法且正在进行研究,以解决共同的潜在素质问题。这些共病疾病的治疗需要纳入针对自杀风险、情绪调节障碍的干预措施,具备创伤知情意识并关注患者参与度。未来的研究应优先研究自闭症谱系障碍与人格障碍共病的病程和预后、饮食失调症与人格障碍共病的新疗法;完善复杂性创伤后应激障碍的概念,并开始研究与人格障碍共病的躯体症状障碍。

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