Inventario PID-5, perfil dimensional del DSM5 para orientar el diagnóstico y las necesidades terapéuticas en los trastornos de personalidad / The PID -5 Inventory: the dimensional profile of DSM5 to guide diagnosis and therapeutic needs in personality disorders

RESUMEN

El Inventario PID-5 de la American Psychiatric Association, evalúa la personalidad y sus trastornos desde el modelo dimensional de rasgos (DSM-5 Sección III), orientando el diagnóstico y las necesidades terapéuticas individuales. Analizamos la utilidad de su aplicación en pacientes derivados a un Hospital de Día para Trastornos de Personalidad (Clústers B y C). En la muestra de 85 sujetos, 51 % son Trastorno Límite (TLP) y 47 % Trastorno de Personalidad No Especificado/Mixto (TPNE/TPM), presentando el 65 % trastornos clínicos comórbidos. Del grupo TLP 89 % son mujeres, 53 % menores de 30 años; en el PID-5 presentan un perfil de mayor gravedad, destacando los Dominios Afecto Negativo y Desinhibición, y las facetas depresión, impulsividad, anhedonia y distraibilidad. Presentan mayor intensidad de síntomas límite (Cuestionario BEST), utilizan menos estrategias de afrontamiento de síntomas y más estrategias de evitación (Cuestionario COPE-28). En el TPNE/TPM, el 58 % son mujeres, 80 % mayores de 30 años, en su perfil del PID-5 destaca afectividad negativa, especialmente la faceta ansiedad. Ambos grupos muestran rasgos límites y evitativos en el screening IPDE. El PID-5 se ha mostrado útil para confirmar diagnósticos específicos (TLP), también para describir el perfil de rasgos y plantear las necesidades terapéuticas concretas tanto en TLP como en TPNE/TPM

ABSTRACT

The PID-5 Inventory of the American Psychiatric Association evaluates personality and related disorders based on the dimensional trait model (DSM-5 Section III), which guides individual diagnosis and therapeutic needs. We analysed its usefulness as it was applied to patients that had been referred to a Day Hospital for Personality Disorders. In the sample of 85 subjects, 51 % had Borderline Personality Disorder (BPD), and 47 % had Personality Disorder NOS or Mixed (PD-NOS/MP), 65 % presenting comorbid clinical disorders. Among the BPD group, 89 % were women, 53 % were under 30 years old; they presented a PID-5 profile of greater severity, the Negative Affect and Disinhibition Domains stood out, as well as the facets of depression, impulsivity, anhedonia and distraction. Their borderline symptoms (BEST scale) were of greater intensity, they used fewer symptom coping strategies and more avoidance strategies (COPE-28 inventory). Among the PD-NOS/MP group, 58 % are women, 80 % were aged over 30 years, and negative affectivity, especially anxiety, stood out in their PID-5 profile. Both groups show borderline and avoidant features in the IPDE screening. The PID-5 was useful for confirming specific diagnoses (BPD), for describing the trait profile as well as proposing the specific therapeutic needs of both BPD and PD-NOS/MP patients