{"title":"边缘型人格障碍妇女和产妇围产期情绪技能小组：可行性随机对照试验的结果。","authors":"Paul Moran, Debra Bick, Lucy Biddle, Belinda Borries, Rebecca Kandiyali, Farah Mgaieth, Vivan Patel, Janice Rigby, Penny Seume, Vaneeta Sadhnani, Nadine Smith, Michaela Swales, Nicholas Turner","doi":"10.1192/bjo.2024.833","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested.</p><p><strong>Aims: </strong>To test the feasibility of conducting a randomised controlled trial (RCT) of perinatal ESGs for women and birthing people with BPD.</p><p><strong>Method: </strong>Two-arm parallel-group feasibility RCT. We recruited people from two centres, aged over 18 years, meeting DSM-5 diagnostic criteria for BPD, who were pregnant or within 12 months of a live birth. Eligible individuals were randomly allocated on a 1:1 ratio to ESGs + treatment as usual (TAU), or to TAU. Outcomes were assessed at 4 months post randomisation.</p><p><strong>Results: </strong>A total of 100% of the pre-specified sample (<i>n</i> = 48) was recruited over 6 months, and we obtained 4-month outcome data on 92% of randomised participants. In all, 54% of participants allocated to perinatal ESGs attended 75% of the full group treatment (median number of sessions: 9 (interquartile range 6-11). At 4 months, levels of BPD symptoms (adjusted coefficient -2.0, 95% CI -6.2 to 2.1) and emotional distress (-2.4, 95% CI -6.2 to 1.5) were lower among those allocated to perinatal ESGs. The directionality of effect on well-being and social functioning also favoured the intervention. 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引用次数: 0
摘要
背景：关于如何在围产期支持边缘型人格障碍（BPD）患者尚无明确的证据。围产期情绪技能小组（esg）可能有所帮助，但其功效尚未经过测试。目的：测试对BPD患者进行围产期esg随机对照试验（RCT）的可行性。方法：双臂平行组可行性随机对照试验。我们从两个中心招募了年龄在18岁以上、符合DSM-5 BPD诊断标准、怀孕或活产12个月内的患者。符合条件的个体按1:1的比例随机分配到esg +常规治疗（TAU）或TAU。随机化后4个月评估结果。结果：在6个月内，100%的预先指定样本（n = 48）被招募，我们获得了92%的随机参与者4个月的结局数据。总的来说，54%的围产期esg参与者参加了75%的全组治疗（中位数：9次（四分位数范围6-11））。在4个月时，围产期esg组的BPD症状（校正系数-2.0,95% CI -6.2至2.1）和情绪困扰（-2.4,95% CI -6.2至1.5）水平较低。对幸福感和社会功能影响的方向性也有利于干预。提供围产期esg的费用估计为每人918英镑。结论：围产期esg可能是围产期妇女和分娩人群BPD的有效干预手段。它们的疗效应该在全功率随机对照试验中进行测试，这是一项可行的工作。试验注册：ISRCTN80470632。
Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial.
Background: There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested.
Aims: To test the feasibility of conducting a randomised controlled trial (RCT) of perinatal ESGs for women and birthing people with BPD.
Method: Two-arm parallel-group feasibility RCT. We recruited people from two centres, aged over 18 years, meeting DSM-5 diagnostic criteria for BPD, who were pregnant or within 12 months of a live birth. Eligible individuals were randomly allocated on a 1:1 ratio to ESGs + treatment as usual (TAU), or to TAU. Outcomes were assessed at 4 months post randomisation.
Results: A total of 100% of the pre-specified sample (n = 48) was recruited over 6 months, and we obtained 4-month outcome data on 92% of randomised participants. In all, 54% of participants allocated to perinatal ESGs attended 75% of the full group treatment (median number of sessions: 9 (interquartile range 6-11). At 4 months, levels of BPD symptoms (adjusted coefficient -2.0, 95% CI -6.2 to 2.1) and emotional distress (-2.4, 95% CI -6.2 to 1.5) were lower among those allocated to perinatal ESGs. The directionality of effect on well-being and social functioning also favoured the intervention. The cost of delivering perinatal ESGs was estimated to be £918 per person.
Conclusions: Perinatal ESGs may represent an effective intervention for perinatal women and birthing people with BPD. Their efficacy should be tested in a fully powered RCT, and this is a feasible undertaking.
期刊介绍：
Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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