Ogrodniczuk John S, Kealy David, Howell-Jones Gail
University of British Columbia, Vancouver, Canada.
J Psychiatr Pract. 2009 Nov;15(6):449-53. doi: 10.1097/01.pra.0000364286.63210.db.
The goal of this study was to develop a sense of how borderline personality disorder (BPD) is treated in the community. The focus was on psychotherapeutic treatments.
A 13-item online questionnaire was distributed to 291 clinicians in the province of British Columbia, Canada. Participants were asked about treatment provision, their opinion of optimal treatment, and clinician confidence using both fixed and open response questions.
The response rate was 43%. Of the respondents, 64% indicated that they provided treatment to patients with BPD, although two thirds of those responses indicated use of ill-defined treatment approaches. In the responses that involved what could be described as well-defined treatment approaches, dialectical behavior therapy (DBT) was the most frequently mentioned (20%). Most treatments were offered in an individual therapy format (60%); 38% described providing treatment on a long-term basis. Responses concerning optimal treatment for BPD favored DBT (45%), a combined individual-group therapy format (48%), and long-term duration of treatment (42%). Clinician confidence in treating BPD was low and there was a strong desire for further training.
The community mental health clinicians who were surveyed were aware of the serious nature of BPD and seek to treat the disorder. However, much of the treatment they provide does not conform to what respondents indicated they considered optimal. Clinicians who responded to the survey seemed relatively unaware of empirically supported psychodynamic treatments for BPD. There is a need for improved training and education regarding BPD and for further dissemination of information concerning empirically supported treatments for BPD.
本研究旨在了解社区中边缘型人格障碍（BPD）的治疗情况。重点是心理治疗方法。
向加拿大不列颠哥伦比亚省的291名临床医生发放了一份包含13个条目的在线问卷。通过固定回答和开放式回答问题，询问参与者有关治疗提供情况、他们对最佳治疗的看法以及临床医生的信心。
回复率为43%。在受访者中，64%表示他们为BPD患者提供治疗，尽管其中三分之二的回复表明使用的是定义不明确的治疗方法。在涉及可被描述为定义明确的治疗方法的回复中，辩证行为疗法（DBT）被提及的频率最高（20%）。大多数治疗以个体治疗形式提供（60%）；38%的人表示提供长期治疗。关于BPD最佳治疗的回复中，支持DBT的占45%，支持个体 - 团体联合治疗形式的占48%，支持长期治疗的占42%。临床医生对治疗BPD的信心较低，并且强烈希望接受进一步培训。
接受调查的社区心理健康临床医生意识到BPD的严重性并试图治疗该疾病。然而，他们提供的许多治疗并不符合受访者认为的最佳治疗方法。参与调查的临床医生似乎相对不了解有实证支持的BPD心理动力治疗方法。需要改进关于BPD的培训和教育，并进一步传播有关有实证支持的BPD治疗方法的信息。
