Short-Term versus Long-Term Mentalization-Based Therapy for Borderline Personality Disorder: A Randomized Clinical Trial (MBT-RCT).

IF 16.3 1区医学 Q1 PSYCHIATRY

Psychotherapy and Psychosomatics Pub Date : 2023-01-01 Epub Date: 2023-11-07 DOI:10.1159/000534289

Sophie Juul, Janus Christian Jakobsen, Emilie Hestbaek, Caroline Kamp Jørgensen, Markus Harboe Olsen, Marie Rishede, Frederik Weischer Frandsen, Sune Bo, Susanne Lunn, Stig Poulsen, Per Sørensen, Anthony Bateman, Sebastian Simonsen

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引用次数: 0

Abstract

Introduction: Borderline personality disorder (BPD) is a severe and prevalent psychiatric disorder. Mentalization-based therapy (MBT) is an evidence-based intervention for BPD, and several countries offer treatment programs for BPD lasting for years, which is resource demanding. No previous trial has compared short-term with long-term MBT.

Objective: The aim of the study was to assess the efficacy and safety of short-term versus long-term MBT for outpatients with BPD.

Methods: Adult outpatients (≥18 years) with subthreshold or diagnosed BPD were randomly assigned (1:1) to short-term MBT (5 months) or long-term MBT (14 months). The primary outcome was BPD symptoms assessed with the Zanarini Rating Scale for Borderline Personality Disorder. Secondary outcomes were functional impairment, quality of life, global functioning, and severe self-harm. All outcomes were primarily assessed at 16 months after randomization. This trial was prospectively registered at ClinicalTrials.gov, NCT03677037.

Results: Between October 4, 2018, and December 3, 2020, we randomly assigned 166 participants to short-term MBT (n = 84) or long-term MBT (n = 82). Regression analyses showed no evidence of a difference when assessing BPD symptoms (MD 0.99; 95% CI: -1.06 to 3.03; p = 0.341), level of functioning (MD 1.44; 95% CI: -1.43 to 4.32; p = 0.321), quality of life (MD -0.91; 95% CI: -4.62 to 2.79; p = 0.626), global functioning (MD -2.25; 95% CI: -6.70 to 2.20; p = 0.318), or severe self-harm (RR 1.37; 95% CI: 0.70-2.84; p = 0.335). More participants in the long-term MBT group had a serious adverse event compared with short-term MBT (RR 1.63; 95% CI: 0.94-3.07; p = 0.088), primarily driven by a difference in psychiatric hospitalizations (RR 2.03; 95% CI: 0.99-5.09; p = 0.056).

Conclusion: Long-term MBT did not lead to lower levels of BPD symptoms, nor did it influence any of the secondary outcomes compared with short-term MBT.

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基于短期和长期心理治疗的边缘型人格障碍：一项随机临床试验（MBT-RCT）。

简介：边缘型人格障碍（BPD）是一种严重而普遍的精神障碍。基于心理的治疗（MBT）是一种基于证据的BPD干预措施，一些国家为BPD提供了持续数年的治疗计划，这对资源要求很高。以前没有对短期和长期MBT进行比较的试验。目的：本研究的目的是评估短期与长期MBT治疗BPD门诊患者的疗效和安全性。方法：将患有阈下或诊断为BPD的成年门诊患者（≥18岁）随机（1:1）分为短期MBT（5个月）或长期MBT（14个月）。主要结果是用Zanarini边缘型人格障碍评定量表评估BPD症状。次要结果是功能损害、生活质量、整体功能和严重的自残。所有结果在随机分组后16个月进行初步评估。该试验在ClinicalTrials.gov，NCT03677037上进行了前瞻性注册。结果：在2018年10月4日至2020年12月3日期间，我们将166名参与者随机分为短期MBT（n=84）或长期MBT（n=82）。回归分析显示，在评估BPD症状（MD 0.99；95%CI:1.06至3.03；p=0.341）、功能水平（MD 1.44；95%CI:1.43至4.32；p=0.321）、生活质量（MD-0.91；95%CI:4.62至2.79；p=0.626）、整体功能（MD-2.25；95%CI:6.70至2.20；p=0.318），或严重的自残（RR 1.37；95%CI:0.70-2.84；p=0.335）。与短期MBT相比，长期MBT组有更多的参与者出现严重不良事件（RR 1.63；95%CI=0.94-30.7；p=0.088），主要是由于精神病住院人数的差异（RR 2.03；95%可信区间0.99-5.09；p=0.056）。结论：长期MBT不会导致BPD症状水平降低，与短期MBT相比，它也没有影响任何次要结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychotherapy and Psychosomatics 医学-精神病学

CiteScore

29.40

自引率

6.10%

发文量

期刊介绍： Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.