Background: Psychosocial oncology research has largely focused on DSM Axis I disorders such as depression and anxiety, while broader psychological dimensions—particularly personality functioning—have received limited attention. In the context of long-term survivorship and chronic cancer care, understanding personality disorders (PDs) is increasingly important. Objective: This systematic review aimed to estimate the prevalence of PDs in adults with cancer based on studies using DSM or ICD diagnostic frameworks. Methods: Following PRISMA guidelines, we systematically searched major electronic databases (PubMed, Scopus, Web of Science) for studies published over the past 45 years that reported PD prevalence in individuals with cancer. Eligible studies employed DSM or ICD criteria for diagnosing PDs. Screening, data extraction, and quality assessments were conducted independently by multiple reviewers. Extracted data included study design, sample characteristics, diagnostic tools, and PD prevalence. Results: Seven studies met the inclusion criteria. Reported prevalence estimates varied widely, ranging from 1.4% to 100%. Most studies were characterized by small sample sizes, cross-sectional designs, and a primary focus on breast cancer populations; only one study included a broader cancer cohort. Study quality was generally low to moderate. A major limitation across studies was the use of unvalidated or non-standardized diagnostic instruments, along with limited methodological detail and heterogeneity in assessment approaches, preventing meaningful pooling of results. Conclusions: The findings reveal a substantial lack of high-quality research examining personality disorders in oncology settings. Robust, methodologically rigorous studies using validated diagnostic tools are urgently needed to clarify the prevalence and clinical relevance of PDs in cancer populations and to inform the development of comprehensive, patient-centered psychosocial care models.
背景：心理社会肿瘤学研究主要聚焦于DSM轴I类障碍（如抑郁和焦虑），而对更广泛的心理维度——尤其是人格功能——的关注有限。在长期生存和慢性癌症照护的背景下，理解人格障碍的重要性日益凸显。目的：本系统综述旨在基于采用DSM或ICD诊断框架的研究，评估成年癌症患者中人格障碍的患病率。方法：遵循PRISMA指南，我们系统检索了主要电子数据库（PubMed、Scopus、Web of Science），收集了过去45年内发表的报告癌症患者人格障碍患病率的研究。符合条件的研究均采用DSM或ICD标准诊断人格障碍。筛选、数据提取和质量评估由多位评审员独立完成。提取的数据包括研究设计、样本特征、诊断工具及人格障碍患病率。结果：七项研究符合纳入标准。报告的患病率估计值差异巨大，范围从1.4%至100%。大多数研究具有样本量小、横断面设计及主要关注乳腺癌人群的特点；仅有一项研究纳入了更广泛的癌症队列。研究质量普遍为低至中等。各研究存在的一个主要局限是使用了未经验证或非标准化的诊断工具，同时方法学细节不足且评估方法存在异质性，导致无法对结果进行有意义的汇总分析。结论：研究结果表明，肿瘤学领域严重缺乏关于人格障碍的高质量研究。亟需采用经过验证的诊断工具开展方法学严谨的稳健研究，以明确癌症人群中人格障碍的患病率及临床相关性，并为制定全面、以患者为中心的心理社会照护模式提供依据。
肿瘤(癌症)患者之家