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共病性人格障碍患者抑郁和焦虑的心理治疗:试验证据的范围研究

Psychological treatment of depression and anxiety in patients with co-morbid personality disorder: A scoping study of trial evidence.

作者信息

French L R M, Turner K M, Dawson S, Moran P

机构信息

Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.

Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.

出版信息

Personal Ment Health. 2017 May;11(2):101-117. doi: 10.1002/pmh.1372.

Abstract

It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd.

摘要

目前尚不清楚对于患有共病性人格障碍的人,治疗其抑郁和焦虑的最佳心理治疗方法是什么。针对该患者群体的不同心理治疗方案的试验已经开展,但此前这些证据尚未得到系统回顾或批判性评估。我们着手进行一项范围综述,以描述哪些心理治疗方法在治疗患有共病性人格障碍的患者的抑郁和/或焦虑方面似乎最有效。我们在PsycINFO、Cochrane图书馆试验库、Medline和Embase数据库中检索了相关研究,这些研究涉及随机对照实验、平行组比较,考察了在门诊环境中针对成年人的任何明确界定的心理治疗干预措施,这些成年人被明确诊断患有抑郁和/或焦虑以及共病性人格障碍。共识别出1662篇论文。其中15篇符合纳入标准并进行了综述。有微弱证据支持将认知行为疗法用作患有共病性人格障碍患者抑郁的心理治疗方法。然而,该文献的特点是存在相当大的方法学异质性,在有足够证据表明哪种心理治疗方法对该患者群体的焦虑和/或抑郁治疗最有效之前,还需要进一步研究。版权所有© 2017约翰威立父子有限公司。

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