强化住院患者辩证行为治疗对心理社会结局的中期影响。

IF 1.3 4区 医学 Q3 PSYCHIATRY
David Mikusky, Niklas Sanhüter, Julia Bauer, Ana Macchia, Sandra Nickel, Birgit Abler
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引用次数: 0

摘要

目的:探讨强化住院辩证行为治疗(DBT)对边缘型人格障碍(BPD)患者心理社会结局和反应预测因素的中期影响。虽然DBT的有效性已得到证实,但对住院治疗后心理社会结果的了解仍然有限。方法:对2021年和2022年在德国南部一所大学医院参加为期8周住院DBT项目的115名BPD患者进行评估。使用简短版的边缘性症状表(BSL-23)评估精神病理变化。在治疗前以及6个月的随访中,使用康复状态评分指征(IRES-3)问卷中的问题收集社会人口学数据和心理社会功能数据。治疗后也评估BSL-23数据。为了检验对治疗反应的预测因子,Jacobson及其同事建议的分类前后比较应用于BSL-23。结果:80%的患者(n=92)完成了治疗。完成治疗的患者比退出治疗的患者年龄大。治疗后(n=83)和6个月随访时(n=35)观察到BPD症状(BSL-23)显著减轻。治疗后效应量较大(Cohen’s d=0.837), 6个月后效应量保持中等(d=0.460)。在心理社会功能方面,患者在治疗6个月后报告社会支持增加,对社会关系的关注减少,生活和工作满意度提高。较高的教育程度是治疗反应的显著预测因子。结论:本文中所描述的强化住院DBT方案显著且持续地减轻了BPD患者的症状,并改善了心理社会结局。教育水平和开始治疗时的年龄可能是治疗成功的关键因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medium-term Effects of Intensified Inpatient Dialectical Behavior Therapy on Psychosocial Outcomes.

Objective: This study investigates the medium-term effects of an intensified inpatient dialectical behavior therapy (DBT) program on psychosocial outcomes and predictors of response in patients with borderline personality disorder (BPD). While the effectiveness of DBT is well established, insights into psychosocial outcomes after inpatient treatment remain limited.

Methods: All 115 patients with BPD who participated in an 8-week inpatient DBT program at a university hospital in southern Germany in 2021 and 2022 were evaluated. Psychopathological changes were assessed using the short version of the Borderline Symptom List (BSL-23). Sociodemographic data and data on psychosocial functioning were collected using questions from the Indications of Rehabilitation Status Score (IRES-3) questionnaire before treatment, as well as at a 6-month follow-up. BSL-23 data were also assessed after treatment. To examine predictors of response to therapy, categorical pre-post comparisons as suggested by Jacobson and colleagues were applied to the BSL-23.

Results: Eighty percent of the patients (n=92) completed the therapy. The patients who completed therapy were older than the dropouts. Significant reductions in BPD symptoms (BSL-23) were observed posttreatment (n=83) and at the 6-month follow-up (n=35). Effect sizes were large posttherapy (Cohen's d=0.837) and remained moderate after 6 months (d=0.460). With regard to psychosocial functioning, patients reported increased social support, fewer concerns about social relationships, and higher life and job satisfaction 6 months after therapy. Higher educational attainment was a significant predictor of treatment response.

Conclusions: The intensified inpatient DBT program described in this article led to significant and sustained reductions in symptoms and improvements in psychosocial outcomes in patients with BPD. Educational levels and age at treatment onset may be critical factors for successful treatment.

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来源期刊
CiteScore
2.30
自引率
10.50%
发文量
159
审稿时长
>12 weeks
期刊介绍: Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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