Steuwe Carolin, Rullkötter Nina, Ertl Verena, Berg Michaela, Neuner Frank, Beblo Thomas, Driessen Martin
Clinic of Psychiatry and Psychotherapy, Bethel, Bielefeld University, Bielefeld, Germany.
Asklepios Fachklinikum Tiefenbrunn, Göttingen, Germany.
BMC Psychiatry. 2016 Jul 20;16:254. doi: 10.1186/s12888-016-0969-4.
This pilot study focused on the feasibility and potential effectiveness of a protocol based on Narrative Exposure Therapy (NET) that was integrated into a standard inpatient program to treat patients with comorbid Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD).
Eleven patients (1 male, 10 female) without previous stabilization periods or the absence of intentional self-injury received NET during a ten-week inpatient program. Patients were assessed again at post-treatment and a 12-month follow-up.
Drop-out rates during treatment were low, with 90.9 % completing NET. Furthermore, acceptance of NET was high, with only one patient rejecting treatment. The program was safe because it did not lead to aggravations in symptom severity at either the post-treatment or 12-month follow-up. Additionally, the rate of self-harming behaviors throughout the treatment phase was low (18.2 %). In fact, treatment was associated with positive effects on PTSD and BPD symptom severity as well as secondary outcome measures, including depression, dissociation and quality of life.
The present study found that NET is feasible and safe in an inpatient setting for treating highly burdened patients with BPD and PTSD. There is also evidence for the potential effectiveness of NET in this highly burdened population.
ClinicalTrials.gov Identifier: NCT02517723 . Registered 6 January 2014.
本试点研究聚焦于一种基于叙事暴露疗法（NET）的方案的可行性和潜在有效性，该方案被纳入标准住院项目以治疗合并边缘型人格障碍（BPD）和创伤后应激障碍（PTSD）的患者。
11名患者（1名男性，10名女性）在为期十周的住院项目中接受了NET治疗，这些患者此前没有病情稳定期或不存在故意自我伤害行为。在治疗后和12个月随访时对患者再次进行评估。
治疗期间的脱落率较低，90.9%的患者完成了NET治疗。此外，NET的接受度较高，只有一名患者拒绝治疗。该项目是安全的，因为在治疗后或12个月随访时均未导致症状严重程度加重。此外，整个治疗阶段的自我伤害行为发生率较低（18.2%）。事实上，治疗对PTSD和BPD症状严重程度以及包括抑郁、分离和生活质量在内的次要结局指标产生了积极影响。
本研究发现，在住院环境中，NET对于治疗负担较重的BPD和PTSD患者是可行且安全的。也有证据表明NET在这一负担较重的人群中具有潜在疗效。
ClinicalTrials.gov标识符：NCT02517723。于2014年1月6日注册。
