Пограничное расстройство личности: к вопросу о диагнозе
https://doi.org/10.31550/1727-2378-2022-21-8-66-71
Аннотация
Цель: обзор и анализ имеющейся современной отечественной и зарубежной литературы, посвященной пограничному расстройству личности.
Основные положения. Обзор посвящен пограничному расстройству личности, актуальность которого обусловлена, в частности, высокой частотой самоповреждающего поведения и коморбидных психических расстройств. Приводятся данные о его распространенности, исторических вехах формирования концепции пограничного расстройства личности, диагностических критериях в МКБ-11 и DSM-5. Дается характеристика клинических проявлений пограничного расстройства, освещаются подходы к дифференциальной диагностике с расстройствами шизофренического и аффективного спектра.
Заключение. Анализ литературы показал возросшую в последние годы как теоретическую, так и практическую значимость пограничного расстройства личности.
Об авторах
Н.. Н. ПетроваРоссия
Петрова Наталия Николаевна — д. м. н., профессор, заведующая кафедрой психиатрии и наркологии
199034, г. Санкт-Петербург, Университетская наб., д. 7-9
Д. И. Чарная
Россия
Чарная Дина Игоревна — врач-психиатр дневного стационара СПБ ГБУЗ «Больница им. П.П. Кащенко»
188357, г. Санкт-Петербург, ул. Канонерская, д. 12
Е. М. Чумаков
Россия
Чумаков Егор Максимович — к. м. н., доцент кафедры психиатрии и наркологии ФГБОУ ВО СПбГУ; заведующий дневным стационаром СПБ ГБУЗ «Больница им. П.П. Кащенко»
188357, г. Санкт-Петербург, ул. Канонерская, д. 12
Список литературы
1. Grant B.F., Chou S.P., Goldstein R.B. et al. Prevalence, correlates, disability, and comorbidity of DSMMIV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J. Clin. Psychiatry. 2008; 69(4): 533– 545. DOI: 10.4088/jcp.v69n0404
2. ten Have M., Verheul R., Kaasenbrood A. et al. Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2. BMC Psychiatry. 2016; 16: 249. DOI: 10.1186/s12888-016-0939-x
3. Tomko R.L., Trull T.J., Wood P.K., Sher K.J. Characteristics of borderline personality disorder in a community sample: comorbidity, treatment utilization, and general functioning. J. Person. Disors. 2014; 28(5): 734–750. DOI: 10.1521/pedi_2012_26_093
4. Volkert J., Gablonski T.C., Rabung S. Prevalence of personality disorders in the general adult population in Western countries: systematic review and meta-analysis. Br. J. Psychiatry. 2018; 213(6): 709–715. DOI: 10.1192/bjp.2018.202
5. Ellison W.D., Rosenstein L.K., Morgan T.A., Zimmerman M. Community and clinical epidemiology of borderline personality disorder. Psychiatr. Clin. North Am. 2018; 41(4): 561–573. DOI: 10.1016/j.psc.2018.07.008
6. Stoffers-Winterling J., Krause-Utz A., Lieb K., Bohus M. Was wissen wir heute über die Borderline-Persönlichkeitsstörung? Aktuelles zu Ätiologie, Diagnostik und Therapie. Nervenarzt. 2021; 92(7): 643–652. DOI: 10.1007/s00115-021-01140-x
7. Leischsenring F., Leibing E., Kruse J. et al. Borderline personality disorder. Lancet. 2011; 377(9759): 74–84. DOI: 10.1016/S0140-6736(10)61422-5
8. Lipovetzky G. Self mutilation in borderline personality disorder. Pain as a self-treatment? A case report. Vertex. 2013; 24(111): 359–362.
9. Zandersen M., Henriksen M.G., Parnas J. A recurrent question: what is borderline? J. Pers. Disord. 2019; 33(3): 341–369. DOI: 10.1521/pedi_2018_32_348
10. Knight R. Borderline states. Bull. Menninger Clin. 1953; 17: 1–12.
11. Stern A. Psychoanalytic investigation of and therapy in the border line group of neuroses. Psychoanalytic Quarterly. 1938; 7: 467–489.
12. Zandersen M., Parnas J. Borderline personality disorder or a disorder within the schizophrenia spectrum? A psychopathological study. World Psychiatry. 2019; 18(1): 109–110. DOI: 10.1002/wps.20598
13. Kernberg O.F., Michels R. Borderline personality disorder. Am. J. Psychiatry. 2009; 166(5): 505–508.
14. Akiskal H.S., Chen S.E., Davis G.C. Borderline: an adjective in search of a noun. J. Clin Psychiatry. 1985; 46: 41–48.
15. Tyrer P. Borderline personality disorder: a motley diagnosis in need of reform. Lancet. 1999; 354(9196): 2095–2096. DOI: 10.1016/S0140-6736(99)00401-8
16. Paris J. The diagnosis of borderline personality disorder: problematic but better than the alternatives. Ann. Clin. Psychiatry. 2005; 17(1): 41–46. DOI: 10.1080/10401230590905461
17. Mulder R.T., Newton-Howes G., Crawford M.J., Tyrer P.J. The central domains of personality pathology in psychiatric patients. J. Pers. Disord. 2011; 25(3): 364–377.
18. Zanarini M.C., Frankenburg F.R., Hennen J. et al. Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. Am. J. Psychiatry. 2004; 161(11): 2108–2114.
19. Watters C.A., Bagby R.M., Sellbom M. Meta-analysis to derive an empirically based set of personality facet criteria for the alternative DSM-5 model for personality disorders. Pers. Disord. 2019; 10(2): 97–104. DOI: 10.1037/per0000307
20. Bach B., Sellbom M. Continuity between DSM-5 categorical criteria and traits criteria for borderline personality disorder. Canad. J. Psychiatry. 2016; 61(8): 489–494.
21. Fowler J.C., Madan A., Allen J.G. et al. Clinical utility of the DSM-5 alternative model for borderline personality disorder: Differential diagnostic accuracy of the BFI, SCID-II-PQ, and PID-5. Comp. Psychiatry. 2018; 80: 97–103. DOI: 10.1016/j.comppsych.2017.09.003
22. World Health Organization. International statistical classification of diseases and related health problems. 11th rev. Geneva; 2018.
23. Zanarini M.C., Gunderson J.G., Frankenburg F.R. Cognitive features of borderline personality disorder. Am. J. Psychiatry. 1990; 147: 57–63.
24. Glaser J.P., Van Os J., Thewissen V., Myin-Germeys I. Psychotic reactivity in borderline personality disorder. Acta Psychiatr. Scand. 2010; 121: 125–134.
25. Adams B., Sanders T. Experiences of psychosis in borderline personality disorder: a qualitative analysis. J. Ment. Health. 2011; 20(4): 381–391. DOI: 10.3109/09638237.2011.577846
26. Hayward M., Jones A.-M., Strawson W.H. et al. A cross-sectional study of auditory verbal hallucinations experienced by people with a diagnosis of borderline personality disorder. Clin. Psychol. Psychother. 2022; 29(2): 631–641. DOI: 10.1002/cpp.2655
27. McGlashan T.H., Grilo C.M., Skodol A.E. et al. The Collaborative Longitudinal Personality Disorders Study: baseline Axis I/II and II/II diagnostic co-occurrence. Acta Psychiatr. Scand. 2000; 102(4): 256– 264. DOI: 10.1034/j.1600-0447.2000.102004256.x
28. Gunderson J.G. Borderline personality disorder: a clinical guide. Washington; 2000: 14–15.
29. Skodol A.E., Gunderson J.G., Pfohl B. et al. The borderline diagnosis I: psychopathology, comorbidity, and personality structure. Biol. Psychiatry. 2002; 51(12): 936–950. DOI: 10.1016/s0006-3223(02)01324-0
30. Wertz J., Caspi A., Ambler A. et al. Borderline symptoms at age 12 signal risk for poor outcomes during the transition to adulthood: findings from a genetically sensitive longitudinal cohort study. J. Am. Acad. Child Adolesc. Psychiatry. 2020; 59(10): 1165–1177. DOI: 10.1016/j.jaac.2019.07.005
31. Stepp S.D., Lazarus S.A. Identifying a borderline personality disorder prodrome: implications for community screening. Person. Mental Health. 2017; 11(3): 195–205. DOI: 10.1002/pmh.1389
32. Miller A.L., Muehlenkamp J.J., Jacobson C.M. Fact or fiction: diagnosing borderline personality disorder in adolescents. Clin. Psychol. Rev. 2008; 28(6): 969–981. DOI: 10.1016/j.cpr.2008.02.004
33. Kaess M., Brunner R., Chanen A. Borderline personality disorder in adolescence. Pediatrics. 2014; 134(4): 782–793. DOI: 10.1542/peds.2013-3677
34. Stepp S.D., Lazarus S.A., Byrd A.L. A systematic review of risk factors prospectively associated with borderline personality disorder: taking stock and moving forward. Person. Disord. 2016; 7(4): 316–323. DOI: 10.1037/per0000186
35. Zanarini M.C., Frankenburg F.R., Ridolfi M.E. et al. Reported childhood onset of self-mutilation among borderline patients. J. Person. Disord. 2006; 20(1): 9–15. DOI: 10.1521/pedi.2006.20.1.9
36. Chabrol H., Montovany A., Chouicha K. et al. Frequency of borderline personality disorder in a sample of French high school students. Canad. J. Psychiatry. 2001; 46(9): 847–849. DOI: 10.1177/070674370104600909
37. Kjaer J.N., Biskin R., Vestergaard C. et al. The clinical trajectory of patients with borderline personality disorder. Personal. Mental Health. 2016; 10(3): 181–190. DOI: 10.1002/pmh.1337
38. Paris J. Differential diagnosis of borderline personality disorder. Psychiatr. Clin. North Am. 2018; 41(4): 575–582. DOI: 10.1016/j.psc.2018.07.001
39. Романов Д.В. Диагностические ошибки врачей-психиатров при распознавании ПРЛ. Известия Самарского научного центра Российской академии наук. 2014; 16(5-4): 1309–1311. [Romanov D.V. Diagnostic mistakes of psychiatrists at recognition the borderline personality disorder. Izvestia of Samara Scientific Center of the Russian Academy of Sciences. 2014; 16(5-4): 1309–1311. (in Russian)]
40. Bayes A., Parker G., Fletcher K. Clinical differentiation of bipolar II disorder from borderline personality disorder. Curr. Opin. Psychiatry. 2014; 27(1): 14–20. DOI: 10.1097/YCO.0000000000000021
41. Carrasco J.L., Mellor-Marsá B., Mallardo L. et al. Persistent psychotic symptoms and neurocognitive deficits in borderline personality disorder. Schizophr. Res. 2021; 232: 109–111. DOI: 10.1016/j.schres.2021.05.003
42. Kaplan B., Yazici Gulec M., Gica S., Gulec H. The association between neurocognitive functioning and clinical features of borderline personality disorder. Braz. J. Psychiatry. 2020; 42(5): 503–509. DOI: 10.1590/1516-4446-2019-0752
43. Thomsen M.S., Ruocco A.C., Carcone D. et al. Neurocognitive deficits in borderline personality disorder: associations with childhood trauma and dimensions of personality psychopathology. J. Person. Disord. 2017; 31(4): 503–521. DOI: 10.1521/pedi_2016_30_265
44. McClure G., Hawes D.J., Dadds M.R. Borderline personality disorder and neuropsychological measures of executive function: a systematic review. Person. Mental Health. 2016; 10(1): 43–57. DOI: 10.1002/pmh.1320
45. Palomares N., García-Andrade R., Arza R. et al. Neuropsychological findings in recent onset schizophrenia and borderline personality disorder: a comparison study. Actas Esp. Psiquiatr. 2019; 47(1): 7–15.
46. Gunderson J.G., Herpertz S.C., Skodol A.E. et al. Borderline personality disorder. Nat. Rev. Dis. Primer. 2018; 4: 18029. DOI: 10.1038/nrdp.2018.29
47. Hirschfeld R.M., Lewis L., Vornik L.A. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J. Clin. Psychiatry. 2003; 64(2): 161–174.
48. Смулевич А.Б. Расстройства личности. Траектория в пространстве психической и соматической патологии. М.; 2012. 336 с.
49. Eskander N., Emamy M., Saad-Omer S.M. et al. The Impact of Impulsivity and emotional dysregulation on comorbid bipolar disorder and borderline personality disorder. Cureus. 2020; 12(8): 9581. DOI: 10.7759/cureus.9581
50. Симуткин Г.Г., Яковлева А.Л. Эффективность фармакотерапии биполярного аффективного расстройства при коморбидности с расстройством личности. Сибирский вестник психиатрии и наркологии. 2017; 3(96): 97–101. DOI: 10.26617/1810-3111-2017-3(96)-97-101
51. Usov G.M., Chumakov E.M., Charnaia D.I. et al. Comorbidity of bipolar affective disorder II type and BOR derline personality disorder. Social and Clinical Psychiatry. 2021; 31(4): 48–56. (in Russian)
52. Sanches M. The limits between bipolar disorder and borderline personality disorder: a review of the evidence. Diseases. 2019; 7(3): 49. DOI: 10.3390/diseases7030049
53. Harned M.S., Chapman A.L., Dexter-Mazza E.T. et al. Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: a 2-year randomized trial of dialectical behavior therapy versus community treatment by experts. J. Consult. Clin. Psychol. 2008; 76(6): 1068–1075. DOI: 10.1037/a0014044
54. Massó Rodriguez A., Hogg B., Gardoki-Souto I. et al. Clinical features, neuropsychology and neuroimaging in bipolar and borderline personality disorder: a systematic review of cross-diagnostic studies. Front. Psychiatry. 2021; 12: 68–76. DOI: 10.3389/fpsyt.2021.681876
55. Биполярное аффективное расстройство: диагностика и терапия. Под ред. С.Н. Мосолова. М.; 2008. 384. [Bipolar affective disorder: diagnosis and therapy. Ed. S.N. Mosolov. Moscow; 2008. 384 p. (in Russian)]
56. Magill C.A. The boundary between borderline personality disorder and bipolar disorder: current concepts and challenges. Can. J. Psychiatry. 2004; 49(8): 551–556. DOI: 10.1177/070674370404900806
57. Bayes A.J., McClure G., Fletcher K. et al. Differentiating the bipolar disorders from borderline personality disorder. Acta Psychiatr. Scand. 2016; 133(3): 187–195. DOI: 10.1111/acps.12509
58. Bellino S., Paradiso E., Bogetto F. Efficacy and tolerability of pharmacotherapies for borderline personality disorder. CNS Drugs. 2008; 22: 671–692. DOI: 10.2165/00023210-200822080-00005
59. Thompson A., Nelson B., Bechdolf A. et al. Borderline personality features and development of psychosis in an 'ultra high risk' (UHR) population: a case control study. Early Interv. Psychiatry. 2012; 6(3): 247–255. DOI: 10.1111/j.1751-7893.2012.00365.x
60. Francey S.M., Jovev M., Phassouliotis C. et al. Does co-occurring borderline personality disorder influence acute phase treatment for firstepisode psychosis? Early Interv. Psychiatry. 2018; 12(6): 1166–1172. DOI: 10.1111/eip.12435
61. Pope H.G., Jonas J.M., Hudson J.I. et al. An empirical study of psychosis in borderline personality disorder. Am. J. Psychiatry. 1985; 142(11): 1285–1290. DOI: 10.1176/ajp.142.11.1285
62. Oliva F., Dalmotto M., Pirfo E. et al. A comparison of thought and perception disorders in borderline personality disorder and schizophrenia: psychotic experiences as a reaction to impaired social functioning. BMC Psychiatry. 2014; 14: 239. DOI: 10.1186/s12888-014-0239-2
63. Barnow S., Arens E.A., Sieswerda S. et al. Borderline personality disorder and psychosis: a review. Curr. Psychiatry Rep. 2010, 12(3): 186–195. DOI: 10.1007/s11920-010-0107-9
64. Kingdon D.G., Ashcroft K., Bhandari B. et al. Schizophrenia and borderline personality disorder: similarities and differences in the experience of auditory hallucinations, paranoia, and childhood trauma. J. Nerv. Ment. Dis. 2010; 198(6): 399–403. DOI: 10.1097/NMD.0b013e3181e08c27
65. Slotema C.W., Daalman K., Blom J.D. et al. Auditory verbal hallucinations in patients with borderline personality disorder are similar to those in schizophrenia. Psychol. Med. 2012, 42(9): 1873–1878. DOI: 10.1017/S0033291712000165
66. Yee L., Korner A.J., McSwiggan S. et al. Persistent hallucinosis in borderline personality disorder. Compr. Psychiatry. 2005, 46(2): 147– 154. DOI: 10.1016/j.comppsych.2004.07.032
67. Pearse L.J., Dibben C., Ziauddeen H. et al. A study of psychotic symptoms in borderline personality disorder. J. Nerv. Ment. Dis. 2014; 202(5): 368–371. DOI: 10.1097/NMD.0000000000000132
68. Gunderson J.G., Phillips K.A. A current view of the interface between borderline personality disorder and depression. Am. J. Psychiatry. 1991; 148(8): 967–975. DOI: 10.1176/ajp.148.8.967
69. Suzuki H., Tsukamoto C., Nakano Y. et al. Delusions and hallucinations in patients with borderline personality disorder. Psychiatry Clin. Neurosci. 1998, 52(6): 605–610. DOI: 10.1046/j.1440-1819.1998.00463.x
70. Cailhol L., Gicquel L., Raynaud J.P. Borderline personality disorder. In: Rey J.M. (ed.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva; 2012. 18 p.
71. Herman J.L., van der Kolk B.A., van der Kolk B.A. Traumatic antecedents of borderline personality disorder. In: Psychological Trauma. Arlington; 1987: 111–126.
72. Frías Á., Palma C. Comorbidity between post-traumatic stress disorder and borderline personality disorder: a review. Psychopathology. 2015; 48(1): 1–10. DOI: 10.1159/000363145
73. Golier J.A., Yehuda R., Bierer L.M. et al. The relationship of borderline personality disorder to posttraumatic stress disorder and traumatic events. Am. J. Psychiatry. 2003; 160(11): 2018–2024. DOI: 10.1176/appi.ajp.160.11.2018
74. Кадыров Р.В., Венгер В.В. Комплексное посттравматическое стрессовое расстройство: современные подходы к определению понятия, этиологии, диагностика и психотерапия. Психолог. 2021; (4): 45–57. DOI: 10.25136/2409-8701.2021.4.35811
75. Hutsebaut J., Videler A.C., Verheul R., Van Alphen S.P.J. Managing borderline personality disorder from a life course perspective: clinical staging and health management. Pers. Disord. 2019; 10(4): 309–316. DOI: 10.1037/per0000341
76. Zanarini M.C., Temes C.M., Frankenburg F.R. et al. Description and prediction of time-to-attainment of excellent recovery for borderline patients followed prospectively for 20 years. Psychiatry Res. 2018; 262: 40–45. DOI: 10.1016/j.psychres.2018.01.034
Рецензия
Для цитирования:
Петрова Н.Н., Чарная Д.И., Чумаков Е.М. Пограничное расстройство личности: к вопросу о диагнозе. Доктор.Ру. 2022;21(8):66-71. https://doi.org/10.31550/1727-2378-2022-21-8-66-71
For citation:
Petrova N.N., Charnaya D.I., Chumakov E.M. Borderline Personality Disorder: Diagnosis. Title. 2022;21(8):66-71. (In Russ.) https://doi.org/10.31550/1727-2378-2022-21-8-66-71