Choi-Kain Lois W, Finch Ellen F, Masland Sara R, Jenkins James A, Unruh Brandon T
Harvard Medical School, McLean Hospital, 115 Mill St., Mail Stop 312, Belmont, MA 02478 USA.
Massachusetts General Hospital, McLean Hospital, Belmont, MA 02478 USA.
Curr Behav Neurosci Rep. 2017;4(1):21-30. doi: 10.1007/s40473-017-0103-z. Epub 2017 Feb 3.
This review summarizes advances in treatments for adults with borderline personality disorder (BPD) in the last 5 years.
Evidence-based advances in the treatment of BPD include a delineation of generalist models of care in contrast to specialist treatments, identification of essential effective elements of dialectical behavioral therapy (DBT), and the adaptation of DBT treatment to manage post-traumatic stress disorder (PTSD) and BPD. Studies on pharmacological interventions remain limited and have not provided evidence that any specific medications can provide stand-alone treatment.
The research on treatment in BPD is leading to a distillation of intensive packages of treatment to be more broadly and practically implemented in most treatment environments through generalist care models and pared down forms of intensive treatments (e.g., informed case management plus DBT skills training groups). Evidence-based integrations of DBT and exposure therapy for PTSD provide support for changing practices to simultaneously treat PTSD and BPD.
本综述总结了过去5年中成人边缘型人格障碍(BPD)治疗方法的进展。
BPD治疗的循证进展包括区分通科护理模式与专科治疗、确定辩证行为疗法(DBT)的基本有效要素,以及调整DBT治疗以管理创伤后应激障碍(PTSD)和BPD。药物干预研究仍然有限,且未提供任何特定药物可单独治疗的证据。
BPD治疗研究正促使将强化治疗方案提炼为通过通科护理模式在大多数治疗环境中更广泛、切实地实施,并简化强化治疗形式(如知情病例管理加DBT技能培训小组)。DBT与PTSD暴露疗法的循证整合为改变治疗方式以同时治疗PTSD和BPD提供了支持。