Originalbeiträge (Originals). Wirksamkeit und Grenzen einer DBT-basierten tagesklinischen Behandlung für Patient:innen mit Borderline-Persönlichkeitsstörung.

Katharina Wolf, René Noack, Andrea Keller, Kerstin Weidner
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Abstract

Effectiveness and limitations of a DBT-informed day-patient treatment for patients with borderline personality disorder Introduction: Borderline personality disorder, a highly prevalent personality disorder is associated with remarkable impairment and is considered one of the most challenging mental illnesses to treat. Dialectical Behavioral Therapy has been recommended by the American Psychiatric Association as a specific treatment for patients with borderline personality disorder. So far, little is known about its effectiveness in a day-patient setting.

Methods: This retrospective longitudinal study investigates changes in symptom burden during an average of 11 weeks of DBT-informed treatment at discharge, and three months after discharge. The symptomatology of n = 178 patients with borderline personality disorder treated from 2009 to 2017 was investigated with established borderline-specific (BSL) and -unspecific questionnaires (BSI-18, BDI) at admission, discharge, and 3-months follow-up by calculating mixed models, effect sizes, and response rates.

Results: 80 % of the patients completed the treatment regularly. In borderline-specific impairments, there were moderate and highly significant improvements with good effects and a response rate of 48 %. Approximately 20 % showed a symptom level equivalent to that of the general population. The strongest effect sizes of approximately .8 were obtained for general psychopathology, with a response rate of 66 %. Results remained stable at follow-up.

Discussion: Similar effects to inpatient treatment with good acceptance and efficacy could be achieved. Effect sizes differed for borderline-specific and unspecific symptoms, suggesting that DBT has different effects on different symptom areas. When comparing responders and non-responders, outpatient psychotherapy appeared to have a positive impact on the therapeutic effect. Furthermore, the results suggest that changes in borderline personality disorder extend over a longer period of time, which may indicate the limitations of curative treatment.

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原创性贡献(Originals)。基于 DBT 的日间门诊治疗对边缘型人格障碍患者的有效性和局限性。
针对边缘型人格障碍患者的 DBT 日间住院治疗的有效性和局限性 简介:边缘型人格障碍是一种高发的人格障碍,具有显著的功能障碍,被认为是最难治疗的精神疾病之一。美国精神病学协会推荐将辩证行为疗法作为边缘型人格障碍患者的一种特殊治疗方法。迄今为止,人们对该疗法在日间患者中的疗效知之甚少:这项回顾性纵向研究调查了出院时平均接受 11 周 DBT 治疗和出院后三个月内症状负担的变化。通过计算混合模型、效应大小和应答率,对2009年至2017年接受治疗的178名边缘型人格障碍患者在入院、出院和3个月随访期间的症状学情况进行了调查,并使用了既有的边缘型特异性(BSL)和非特异性问卷(BSI-18、BDI):80%的患者定期完成了治疗。在边界特异性损伤方面,患者的症状有中度和高度显著改善,效果良好,应答率为 48%。约 20% 的患者的症状水平与普通人群相当。在一般精神病理学方面取得了约0.8的最强效应大小,应答率为66%。随访结果保持稳定:讨论:疗效与住院治疗相似,具有良好的可接受性和有效性。边际特异性症状和非特异性症状的效应大小不同,这表明 DBT 对不同症状领域有不同的效果。在比较有反应者和无反应者时,门诊心理治疗似乎对治疗效果有积极影响。此外,研究结果表明,边缘型人格障碍的改变持续时间较长,这可能表明了治疗方法的局限性。
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来源期刊
CiteScore
1.50
自引率
11.10%
发文量
30
审稿时长
>12 weeks
期刊介绍: This journal provides a systematic overview of the entire field of psychosomatic medicine. It is also the official organ of the German Society for Psychosomatic Medicine and Medical Psychotherapy (DGPM). It serves as a forum for discussions of the interdisciplinary experiences in the field of psychosomatics, the goal being the furtherance of scientific insights into the interactions between mental and physical factors in the development of disease. It also provides a way to deepen one´s knowledge of psychoanalysis and to explore new therapeutic directions.
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