Karterud Sigmund, Pedersen Geir, Bjordal Elin, Brabrand Jørgen, Friis Svein, Haaseth Oyvind, Haavaldsen Grete, Irion Torill, Leirvåg Harald, Tørum Elin, Urnes Oyvind
Department for Personality Psychiatry, Psychiatric Division, Ullevål University Hospital, Oslo, Norway.
J Pers Disord. 2003 Jun;17(3):243-62. doi: 10.1521/pedi.17.3.243.22151.
This study sought to investigate the following research questions: Are time-limited day treatment programs for patients with personality disorder (PD) effective outside resourceful university settings, and what are the overall treatment results when the program is implemented on a larger scale? Do all categories and subtypes of PDs respond favorably to such treatment? How intensive should such day treatment programs be? All patients (n = 1,244) were consecutively admitted to eight different treatment programs in the Norwegian Network of Psychotherapeutic Day Hospitals from 1993 to 2000. Altogether, 1,010 patients were diagnosed with PD. Avoidant, borderline, not otherwise specified (NOS), and paranoid PD were the most common conditions. SCID-II and MINI were used as diagnostic instruments. Outcome measures included GAF Global Assessment of Functioning, (GAF; American Psychiatric Association, 1994), SCL-90R, CIP, Quality of Life, work functioning and parasuicidal behavior, measured at admittance, discharge and 1-year follow up. The attrition rate was 24%. The number of dropouts did not improve over time. As a group, completers with PD improved significantly on all outcome variables from admittance to discharge and improvement was maintained or increased at follow up. Treatment results were best for borderline PD, cluster C patients, PD NOS and No PD, and poorer for cluster A patients. Units with a high treatment dosage did not experience better outcomes than those with a low treatment dosage (10 hours per week). Results from the University unit were not better than those from units at local hospitals or mental health centers.
针对人格障碍（PD）患者的限时日间治疗项目在资源丰富的大学环境之外是否有效，以及该项目大规模实施时的总体治疗效果如何？所有PD类别和亚型对这种治疗的反应是否良好？这种日间治疗项目的强度应该多大？1993年至2000年期间，共有1244名患者连续被纳入挪威心理治疗日间医院网络的八个不同治疗项目。总共有1010名患者被诊断为PD。回避型、边缘型、未特定的（NOS）和偏执型PD是最常见的类型。使用SCID-II和MINI作为诊断工具。结果测量包括在入院、出院和1年随访时测量的总体功能评定量表（GAF；美国精神病学协会，1994年）、症状自评量表（SCL-90R）、临床总体印象量表（CIP）、生活质量、工作功能和准自杀行为。脱落率为24%。随着时间的推移，退出人数没有改善。总体而言，患有PD的完成治疗者在从入院到出院的所有结果变量上都有显著改善，并且在随访时改善得以维持或增加。边缘型PD、C类患者、未特定的PD患者和非PD患者的治疗效果最佳，A类患者的治疗效果较差。高治疗剂量单位的治疗效果并不比低治疗剂量单位（每周10小时）更好。大学单位的结果并不比当地医院或心理健康中心单位的结果更好。
