Chanen Andrew M, Jackson Henry J, McCutcheon Louise K, Jovev Martina, Dudgeon Paul, Yuen Hok Pan, Germano Dominic, Nistico Helen, McDougall Emma, Weinstein Caroline, Clarkson Verity, McGorry Patrick D
ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Australia.
Br J Psychiatry. 2008 Dec;193(6):477-84. doi: 10.1192/bjp.bp.107.048934.
No accepted intervention exists for borderline personality disorder presenting in adolescence.
To compare the effectiveness of up to 24 sessions of cognitive analytic therapy (CAT) or manualised good clinical care (GCC) in addition to a comprehensive service model of care.
In a randomised controlled trial, CAT and GCC were compared in out-patients aged 15-18 years who fulfilled two to nine of the DSM-IV criteria for borderline personality disorder. We predicted that, compared with the GCC group, the CAT group would show greater reductions in psychopathology and parasuicidal behaviour and greater improvement in global functioning over 24 months.
Eighty-six patients were randomised and 78 (CAT n=41; GCC n=37) provided follow-up data. There was no significant difference between the outcomes of the treatment groups at 24 months on the pre-chosen measures but there was some evidence that patients allocated to CAT improved more rapidly. No adverse effect was shown with either treatment.
Both CAT and GCC are effective in reducing externalising psychopathology in teenagers with sub-syndromal or full-syndrome borderline [corrected] personality disorder. Larger studies are required to determine the specific value of CAT in this population.
目前尚无被认可的针对青少年边缘型人格障碍的干预措施。
比较多达24节认知分析疗法（CAT）或手册化优质临床护理（GCC）结合综合护理服务模式的有效性。
在一项随机对照试验中，对符合DSM-IV边缘型人格障碍标准中2至9条的15至18岁门诊患者进行CAT和GCC的比较。我们预测，与GCC组相比，CAT组在24个月内精神病理学和准自杀行为的减少幅度更大，整体功能改善更明显。
86名患者被随机分组，78名（CAT组n = 41；GCC组n = 37）提供了随访数据。在24个月时，根据预先选定的测量指标，治疗组的结果没有显著差异，但有一些证据表明分配到CAT组的患者改善得更快。两种治疗均未显示出不良反应。
CAT和GCC在减少亚综合征或全综合征边缘型人格障碍青少年的外化精神病理学方面均有效。需要更大规模的研究来确定CAT在该人群中的具体价值。
