Waldinger R J, Frank A F
Psychosocial Research Program McLean Hospital, Belmont, Massachusetts 02178.
Hosp Community Psychiatry. 1989 Jul;40(7):712-8. doi: 10.1176/ps.40.7.712.
Combining pharmacotherapy and psychotherapy in the treatment of borderline personality disorder is increasingly common, yet the experiences of clinicians who use the two modalities have not been studied. Forty psychotherapists were surveyed about their prescribing practices with borderline patients. Results corroborate the clinical impression that therapists' decisions about medication use are influenced by psychosocial factors as well as by target symptoms. Therapists were most likely to prescribe medications when they felt pessimistic about patients' capacity to benefit from psychotherapy and were rarely willing to prescribe medications for patients who had a history of substance abuse or suicide attempts. An average of 47 percent of the borderline patients in the therapists' practices misused prescription medications. Patients were most likely to abuse medications after experiencing an interpersonal loss or failure.
在边缘型人格障碍的治疗中，联合药物治疗和心理治疗越来越普遍，但使用这两种治疗方式的临床医生的经历尚未得到研究。对40名心理治疗师进行了关于他们对边缘型患者开药做法的调查。结果证实了临床印象，即治疗师关于用药的决定受心理社会因素以及目标症状的影响。当治疗师对患者从心理治疗中获益的能力感到悲观时，他们最有可能开药，而对于有药物滥用或自杀未遂史的患者，他们很少愿意开药。在治疗师的治疗实践中，平均47%的边缘型患者滥用处方药。患者在经历人际丧失或失败后最有可能滥用药物。
