Leppänen Virpi, Kärki Anna, Saariaho Tom, Lindeman Sari, Hakko Helinä
Institute of Clinical Medicine, Psychiatry, University of Oulu, Finland; City of Oulu, Social and Health Services, Mental Health Services, Finland.
Scand J Psychol. 2015 Feb;56(1):78-85. doi: 10.1111/sjop.12172. Epub 2014 Oct 30.
Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema-focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ-L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.
边缘性人格障碍（BPD）是一种相对常见且严重的精神障碍，会在许多方面损害生活质量。本研究的目的是确定一种针对BPD患者的联合治疗模式，该模式运用了聚焦图式疗法（SFT）和辩证行为疗法（DBT）的主要原则，与常规治疗（TAU）相比，是否能更有效地缓解BPD患者的早期适应不良图式。本研究是在奥卢市社会和医疗服务机构运营的精神卫生保健服务中进行的奥卢BPD研究的一部分。该研究是一项为期一年的多中心随机对照试验，涉及两组重度BPD患者：（1）由专家进行社区治疗（CTBE）的患者（n = 18）接受联合治疗模式，以及（2）常规治疗患者（n = 27）。在治疗一年前后，使用杨氏图式问卷（YSQ-L3a）对患者的图式进行评估。结果显示，接受联合治疗模式的CTBE患者在18种早期适应不良图式中的8种上有统计学显著降低，而接受常规治疗的患者在图式方面未显示出任何显著变化。这种认知治疗模式可以利用现有的专业人员应用于公共心理健康环境中的临床治疗，并且似乎能给BPD患者带来积极变化。
