Abbass Allan, Sheldon Albert, Gyra John, Kalpin Allen
Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
J Nerv Ment Dis. 2008 Mar;196(3):211-6. doi: 10.1097/NMD.0b013e3181662ff0.
This study evaluated the efficacy and long-term effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of patients with DSM-IV personality disorders (PD). Twenty-seven patients with PD were randomized to treatment with ISTDP or a minimal-contact, delayed-treatment control condition. ISTDP-treated patients improved significantly more than controls on all primary outcome indices, reaching the normal ranges on both the brief symptom inventory (1.51-0.51, p < 0.001) and inventory of interpersonal problems (1.56-0.67, p < 0.001). When control patients were treated, they experienced benefits similar to the initial treatment group. In long-term follow-up, the whole group maintained their gains and had an 83.3% reduction of personality disorder diagnoses. Treatment costs were thrice offset by reductions in medication and disability payments. This preliminary study of ISTDP suggests it is efficacious and cost-effective in the treatment of PD. Limitations of this study and suggestions for future research are discussed.
本研究评估了强化短期动力心理治疗(ISTDP)在治疗符合《精神疾病诊断与统计手册》第四版(DSM-IV)人格障碍(PD)患者中的疗效及长期有效性。27名人格障碍患者被随机分配接受ISTDP治疗或最小接触、延迟治疗的对照条件。接受ISTDP治疗的患者在所有主要结局指标上的改善均显著优于对照组,在简明症状量表(1.51 - 0.51,p < 0.001)和人际问题量表(1.56 - 0.67,p < 0.001)上均达到正常范围。当对照患者接受治疗时,他们获得了与初始治疗组相似的益处。在长期随访中,整个组维持了他们的改善成果,人格障碍诊断减少了83.3%。治疗成本因药物和残疾支付的减少而得到三倍的抵消。这项关于ISTDP的初步研究表明,它在人格障碍治疗中是有效且具有成本效益的。本文讨论了本研究的局限性及对未来研究的建议。