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
{"title":"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）。","authors":"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","doi":"10.1159/000534289","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Objective: </strong>The aim of the study was to assess the efficacy and safety of short-term versus long-term MBT for outpatients with BPD.</p><p><strong>Methods: </strong>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 <ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link>, NCT03677037.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"329-339"},"PeriodicalIF":16.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716869/pdf/","citationCount":"0","resultStr":"{\"title\":\"Short-Term versus Long-Term Mentalization-Based Therapy for Borderline Personality Disorder: A Randomized Clinical Trial (MBT-RCT).\",\"authors\":\"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\",\"doi\":\"10.1159/000534289\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Objective: </strong>The aim of the study was to assess the efficacy and safety of short-term versus long-term MBT for outpatients with BPD.</p><p><strong>Methods: </strong>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 <ext-link ext-link-type=\\\"uri\\\" xlink:href=\\\"http://ClinicalTrials.gov\\\" xmlns:xlink=\\\"http://www.w3.org/1999/xlink\\\">ClinicalTrials.gov</ext-link>, NCT03677037.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":20744,\"journal\":{\"name\":\"Psychotherapy and Psychosomatics\",\"volume\":\" \",\"pages\":\"329-339\"},\"PeriodicalIF\":16.3000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716869/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychotherapy and Psychosomatics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000534289\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/11/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychotherapy and Psychosomatics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000534289","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/7 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Short-Term versus Long-Term Mentalization-Based Therapy for Borderline Personality Disorder: A Randomized Clinical Trial (MBT-RCT).
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.
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.
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