Centre for Brain and Mental Health Research, University of Newcastle, New South Wales, Australia.
Aust N Z J Psychiatry. 2010 Feb;44(2):162-73. doi: 10.3109/00048670903393621.
Deliberate self-harm (DSH), general hospital admission and psychiatric hospital admission are common in women meeting criteria for borderline personality disorder (BPD). Dialectical behaviour therapy (DBT) has been reported to be effective in reducing DSH and hospitalization.
A randomized controlled trial of 73 female subjects meeting criteria for BPD was carried out with intention-to-treat analyses and per-protocol analyses. The intervention was DBT and the control condition was treatment as usual plus waiting list for DBT (TAU+WL), with outcomes measured after 6 months. Primary outcomes were differences in proportions and event rates of: any DSH; general hospital admission for DSH and any psychiatric admission; and mean difference in length of stay for any hospitalization. Secondary outcomes were disability and quality of life measures.
Both groups showed a reduction in DSH and hospitalizations, but there were no significant differences in DSH, hospital admissions or length of stay in hospital between groups. Disability (days spent in bed) and quality of life (Physical, Psychological and Environmental domains) were significantly improved for the DBT group.
DBT produced non-significant reductions in DSH and hospitalization when compared to the TAU+WL control, due in part to the lower than expected rates of hospitalization in the control condition. Nevertheless, DBT showed significant benefits for the secondary outcomes of improved disability and quality of life scores, a clinically useful result that is also in keeping with the theoretical constructs of the benefits of DBT.
蓄意自伤（DSH）、综合医院入院和精神病院入院在符合边缘型人格障碍（BPD）标准的女性中很常见。辩证行为疗法（DBT）已被报道可有效减少 DSH 和住院。
对 73 名符合 BPD 标准的女性进行了一项随机对照试验，采用意向治疗分析和方案分析。干预措施是 DBT，对照组为常规治疗加 DBT 的等待名单（TAU+WL），在 6 个月后测量结果。主要结果是比较两组之间：任何 DSH 的比例和发生率差异；因 DSH 而入住综合医院和任何精神科入院的比例和发生率差异；以及任何住院的平均住院时间差异。次要结果是残疾和生活质量测量。
两组 DSH 和住院人数均有所减少，但两组之间 DSH、住院人数或住院时间无显著差异。DBT 组的残疾（卧床天数）和生活质量（身体、心理和环境领域）显著改善。
与 TAU+WL 对照组相比，DBT 对 DSH 和住院的减少没有显著效果，部分原因是对照组的住院率低于预期。尽管如此，DBT 在改善残疾和生活质量评分的次要结果方面显示出显著的益处，这是一个临床有用的结果，也符合 DBT 的理论构建。
