Ng Fiona Y Y, Bourke Marianne E, Grenyer Brin F S
School of Psychology, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.
PLoS One. 2016 Aug 9;11(8):e0160515. doi: 10.1371/journal.pone.0160515. eCollection 2016.
Longitudinal studies support that symptomatic remission from Borderline Personality Disorder (BPD) is common, but recovery from the disorder probably involves a broader set of changes in psychosocial function over and above symptom relief. A systematic review of literature on both symptomatic and personal recovery from BPD was conducted including the views of consumers, clinicians, family and carers.
A PRISMA guided systematic search identified research examining the process of recovery from BPD. Longitudinal studies with a follow-up period of five or more years were included to avoid treatment effects.
There were 19 studies, representing 11 unique cohorts (1,122 consumers) meeting the review criteria. There was a limited focus on personal recovery and the views of family and carers were absent from the literature. Rates of remission and recovery differ depending upon individual and methodological differences between studies. Data on symptomatic remission, recurrence and diagnosis retainment suggests that BPD is a stable condition, where symptomatic remission is possible and the likelihood of recurrence following a period of remission is low.
Symptomatic remission from BPD is common. However, recovery including capacities such as engaging in meaningful work was seldom described. Future research needs broader measures of recovery as a sub-syndromal experience, monitoring consumer engagement in meaningful vocation and relationships, with or without the limitations of BPD.
纵向研究表明,边缘型人格障碍(BPD)的症状缓解很常见,但从该障碍中恢复可能涉及症状缓解之外更广泛的心理社会功能变化。我们对关于BPD症状缓解和个人恢复的文献进行了系统综述,纳入了患者、临床医生、家庭和护理人员的观点。
在PRISMA指导下进行系统检索,以确定研究BPD恢复过程的研究。纳入随访期为五年或更长时间的纵向研究,以避免治疗效果的影响。
有19项研究,代表11个独特队列(1122名患者)符合综述标准。对个人恢复的关注有限,文献中缺乏家庭和护理人员的观点。缓解率和恢复率因研究之间的个体差异和方法差异而有所不同。关于症状缓解、复发和诊断保留的数据表明,BPD是一种稳定的疾病,症状缓解是可能的,缓解一段时间后复发的可能性较低。
BPD的症状缓解很常见。然而,很少描述包括从事有意义工作等能力的恢复情况。未来的研究需要更广泛地衡量作为亚综合征体验的恢复情况,监测患者在有意义的职业和人际关系中的参与情况,无论是否存在BPD的限制。