人格障碍

最后审阅: 28 四月 2022
最后更新: 16 九月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 偏执
  • 古怪思维
  • 限制情绪范围
  • 愤怒和易激惹
  • 过度情绪化和不稳定的心境状态
  • 焦虑和紧张
  • 冲动行为
  • 自大
  • 自伤的证据(如,瘢痕、烧伤)
更多 关键诊断因素

危险因素

  • 虐待史
  • 精神分裂症家族史
  • 不利的父母养育作用
  • 儿童期情绪/分裂性障碍
更多 危险因素

诊断性检查

首要检查

  • 临床访谈
更多 首要检查

需考虑的检查

  • 自杀风险筛查问卷
  • 标准化的简明人格评估量表(SAPAS)
  • 米隆临床多轴问卷第三版 (MCMI-III)
  • DSM-5 人格障碍替代模型的结构化临床访谈版(SCID-5-AMPD)
  • DSM-5 人格障碍的结构化临床访谈
  • MRI/CT脑扫描
  • 尿液药物筛查
  • 精神障碍的初级评定(PRIME-MD)
  • 患者健康问卷-9 (PHQ-9)
  • 情绪障碍问卷
  • 广泛焦虑障碍-7(GAD-7)和广泛焦虑障碍-2(GAD-2)量表
更多 需考虑的检查

治疗流程

急症处理

有自我伤害或伤害他人的风险,或不能满足自我需要

持续性治疗

A类:奇特/古怪:无生命威胁

B类(表演型):无生命威胁

C类(焦虑的):无生命威胁

人格障碍的多特征:无生命威胁

撰稿人

作者

Michael J. Schrift, DO, MA
Michael J. Schrift

Professor

Department of Psychiatry and Behavioral Sciences

University of Washington

Seattle

WA

利益声明

MJS declares he has no competing interests.

鸣谢

Dr Michael J. Schrift would like to gratefully acknowledge Dr Crystal T. Clark, and the late Dr Maria Devens, previous contributors to this topic. He would also like to acknowledge Dr Eric Gausche, who contributed the psychopharmacology sections for the initial version, and Dr Richard Stringham, who reviewed and approved information on the use of imaging and laboratory tests in the diagnosis section in the initial version. MD was an author of references cited in this topic. CTC, EG, and RS declare that they have no competing interests.

同行评议者

Anthony W. Bateman, FRCPsych

Consultant Psychiatrist and Visiting Professor

Halliwick Psychotherapy Unit

St Ann’s Hospital

London

UK

利益声明

AWB declares that he has a bias towards the use of mentalization in the treatment of personality disorder.

Robin L. Kissell, MD

Director

Borderline Personality Disorder Initiative

Semel Institute

UCLA

Los Angeles

CA

利益声明

RLK declares that she has no competing interests.

Justin Trevino, MD

Medical Director

Opioid Treatment Program

Dayton Veterans Affairs Medical Center

Dayton

OH

利益声明

JT declares that he has no competing interests.

Dietmar Winkler, MD

Department of Psychiatry and Psychotherapy

Medical University of Vienna

Vienna

Austria

利益声明

DW has received lecture fees from CSC Pharmaceuticals, GlaxoSmithKline, and Pfizer, and has served as a consultant for GlaxoSmithKline.

  • 鉴别诊断

    • 心境障碍
    • 精神病性障碍
    • 焦虑障碍
    更多 鉴别诊断
  • 指南

    • 人格障碍治疗指南
    • 在初级医疗机构筛查青少年、成年、老年人的自杀风险
    更多 指南
  • 患者教育信息

    人格障碍:是什么?

    人格障碍:如何有效治疗?

    更多 患者教育信息
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