Center for Personality Disorders, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126 Turin, Italy.
Center for Personality Disorders, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126 Turin, Italy.
Psychiatry Res. 2016 Jun 30;240:151-156. doi: 10.1016/j.psychres.2016.04.014. Epub 2016 Apr 13.
Few investigations evaluated the long-term effects of psychotherapies in borderline personality disorder (BPD). In a previous study, we compared efficacy of combination of fluoxetine and interpersonal psychotherapy adapted to BPD (IPT-BPD) versus single fluoxetine administered for 32 weeks. This study is aimed to investigate whether the results obtained with the addition of IPT-BPD persist during a follow-up period. Forty-four patients who completed the 32 weeks trial underwent 24 months of follow-up receiving fluoxetine 20-40 mg/day. Clinical Global Impression Severity (CGI-S), Hamilton Rating Scales for Depression and Anxiety (HDRS, HARS), Social and Occupational Functioning Assessment Scale (SOFAS), Satisfaction Profile (SAT-P), and Borderline Personality Disorder Severity Index (BPDSI) were repeated at 6, 12, and 24 months. Statistical analysis was performed with the general linear model. Results showed that most of the differences between combined therapy and single pharmacotherapy at the end of the 32 weeks trial were maintained after 24 months follow-up. The addition of IPT-BPD to medication produced greater effects on BPD symptoms (impulsivity and interpersonal relationships) and quality of life (perception of psychological and social functioning) that endured after termination of psychotherapy. On the contrary, different effects on anxiety symptoms and affective instability were lost after 6 months.
很少有研究评估心理治疗在边缘型人格障碍(BPD)中的长期效果。在之前的一项研究中,我们比较了氟西汀联合适应 BPD 的人际心理治疗(IPT-BPD)与单一氟西汀治疗 32 周的疗效。本研究旨在探讨在 24 个月的随访期间,加入 IPT-BPD 是否能保持之前的研究结果。44 名完成 32 周试验的患者接受了 24 个月的氟西汀 20-40mg/天的随访治疗。在第 6、12 和 24 个月时,重复使用临床总体印象严重程度量表(CGI-S)、汉密尔顿抑郁和焦虑量表(HDRS、HARS)、社会和职业功能评估量表(SOFAS)、满意度量表(SAT-P)和边缘型人格障碍严重程度指数(BPDSI)。采用一般线性模型进行统计分析。结果表明,在 32 周试验结束时,联合治疗与单一药物治疗之间的大多数差异在 24 个月随访后仍能维持。与药物治疗相比,添加 IPT-BPD 可对 BPD 症状(冲动和人际关系)和生活质量(心理和社会功能的感知)产生更大的影响,且这种影响在心理治疗结束后仍能持续。相反,在 6 个月后,对焦虑症状和情感不稳定的不同影响消失了。