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Anxiété et personnalité: études catégorielle et dimensionnelle de leur association et facteurs de vulnérabilité

Anxiety and personality: Categorical and dimensional studies of their association and vulnerability factors

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Résumé

Les troubles anxieux surviennent souvent chez des patients semblant présenter des traits de personnalité particuliers, voire de véritables personnalités pathologiques. Ce constat clinique conduit à s’interroger sur les interactions respectives entre anxiété et personnalité: peut-on évaluer de manière valide la personnalité de patients anxieux, quelle est la comorbidité dité réelle entre troubles anxieux et troubles de la personnalité, et quels liens éventuellement physiopathologiques les unissent? Les études basées sur une approche catégorielle des troubles de la personnalité concluent à une prévalence d’environ 40 à 60% de ceux-ci chez les patients souffrant de trouble anxieux. Les catégories les plus représentées appartiennent au “cluster C”, avec une majorité de personnalités évitantes et dépendantes, sans spécificité réelle en fonction du type d’anxiété. Les approches dimensionnelles confirment l’existence de traits d’évitement chez les patients souffrant de troubles anxieux, à un niveau parfois très élevé, et cela même après traitement de l’anxiété. Ces travaux conforteraient l’hypothèse selon laquelle certains traits de tempérament, sous-tendus par des dispositions biologiques stables et héritables, peuvent constituer des facteurs de vulnérabilité précoce à l’apparition de troubles anxieux.

Abstract

Anxiety disorders often appear in patients with particular personality traits, and in some cases with actual personality disorders. This clinical observation may question the respective interactions between personality and anxiety disorders: Is it possible to evaluate the personality of patients with severe anxiety disorders reliably? What is the real co-morbidity between personality disorders and anxiety disorders? Are there psychopathological and etiological links between these two disorders? Studies relying on categorical approaches of personality suggest that about 40-60% of anxious patients fulfill the diagnostic criteria of at least one personality disorder. The most frequent diagnoses belong to the cluster C of the DSM-IV axis II classification, with a majority having avoidant and dependent personalities, but without any real specificity according to the types of anxiety disorders. On the other hand, dimensional studies have shown that anxiety disorders are often associated with avoidant personality traits, with very deviant scores in some cases, even after treatment of the anxiety disorder. These works support the existence of some temperament traits, underlined by psychobiological, stable, and inheritable dimensions, which may constitute early vulnerability factors for anxiety disorders in both children and adults.

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  1. Interne en psychiatrie, Paris

    Cédric Lemogne

  2. CNRS UMR 7593, Paris

    Antoine Pélissolo (Psychiatre, praticien hospitalier)

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Lemogne, C., Pélissolo, A. Anxiété et personnalité: études catégorielle et dimensionnelle de leur association et facteurs de vulnérabilité. Psychiatr Sci Hum Neurosci 2, 24–37 (2004). https://doi.org/10.1007/BF03005999

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