A compromise solution between overlapping and overlooking DSM personality disorders in Chinese psychiatric practice

作者：Zhu, SuoYu; Zhang, TianHong^*; Yang, ChengQing; Wei, YanYan; Xu, LiHua; Wang, JunJie; Chow, Annabelle; Liu, XiaoHua; Jiang, KaiDa; Xiao, ZePing; Zhou, Hui^*; Wang, JiJun

来源：Social Psychiatry and Psychiatric Epidemiology, 2018, 53(1): 99-106.

DOI：10.1007/s00127-017-1444-3

• Diagnosis
• Personality disorder
• Comorbidity
• Classification
• China

This study aimed to examine the overlaps between the Diagnostic and Statistical Manual-5 (DSM-5) Personality Disorders (PDs) in a high-risk clinical population and to explore a transitional model for implementing DSM-5 PDs.
A sample population of 982 outpatients with at least one diagnosed PD was selected from 3,075 outpatients of the Shanghai Mental Health Center. The diagnostic process comprised of a personality diagnostic questionnaire and a structured clinical interview.
685 (22.3%) patients were diagnosed with at least one of six PDs (antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, and schizotypal) under the alternative DSM-5 model for personality disorders proposed in Section III of the DSM-5. Nearly 20.3% of the subjects with PD met criteria for at least two PDs (of the 685 PD patients/6 PD model). Cluster and principal component analyses suggest a transitional model for the 7 specific PD categories (among the 722 PD patients, the overlapping rate was 24.1%) will be more appropriate for PD diagnosis in China.
Using the simplified PD categories in the alternative DSM-5 model for personality disorders will reduce the overlaps in PD diagnoses in Chinese psychiatric practice, and should be preferred over the DSM-5 PD diagnostic system.

• 出版日期2018-1
• 单位上海市精神卫生中心; 复旦大学; 上海交通大学