Simonsen Sebastian, Heinskou Torben, Sørensen Per, Folke Sofie, Lau Marianne Engelbrecht
a Research Unit , Stolpegaard Psychotherapy Centre , Gentofte , Denmark.
b Department of Personality Disorders and Trauma , Stolpegaard Psychotherapy Centre , Gentofte , Denmark.
Nord J Psychiatry. 2017 Jul;71(5):325-331. doi: 10.1080/08039488.2017.1284262. Epub 2017 Feb 13.
In this naturalistic study, patients with personality disorders (N = 388) treated at Stolpegaard Psychotherapy Center, Mental Health Services, Capital Region of Denmark were allocated to two different kinds of treatment: a standardized treatment package with a preset number of treatment hours (basic hospital service) and 2: a specialized treatment program for the most severely affected patients without a predetermined restricted number of treatment hours and significantly more individual psychotherapy (regional specialized hospital services).
To investigate patient characteristics associated with clinicians' allocation of patients to the two different personality disorder services.
Patient characteristics across eight domains were collected in order to study whether there were systematic differences between patients allocated to the two different treatments. Patient characteristics included measures of symptom severity, personality pathology, trauma and socio-demographic characteristics. Significance testing and binary regression analysis were applied to identify important predictors.
Patient characteristics on fifteen variables differed significantly, all in the expected direction, with patients in regional specialized hospital services showing more pathology and psychosocial problems. In the regression model, only age and two variables capturing psychosocial functioning remained significant predictors of allocation.
The finding that younger age was the most significant predictor of longer treatment replicates an earlier finding of allocation to treatment for personality disorder. Overall, this study therefore lends further support to the importance of demographic and social contextual factors in clinicians' allocation of patients to different treatment services for personality disorder.
在这项自然主义研究中，丹麦首都地区心理健康服务机构斯托尔佩加德心理治疗中心收治的人格障碍患者（N = 388）被分配到两种不同的治疗方式：一种是有预设治疗时长的标准化治疗方案（基本医院服务），另一种是针对病情最严重患者的专门治疗项目，该项目没有预先设定的治疗时长限制，且有更多的个体心理治疗（地区专科医院服务）。
调查与临床医生将患者分配到两种不同人格障碍服务相关的患者特征。
收集了八个领域的患者特征，以研究分配到两种不同治疗方式的患者之间是否存在系统差异。患者特征包括症状严重程度、人格病理学、创伤和社会人口学特征的测量指标。应用显著性检验和二元回归分析来确定重要的预测因素。
15个变量的患者特征存在显著差异，均符合预期方向，地区专科医院服务的患者表现出更多的病理学和心理社会问题。在回归模型中，只有年龄和两个反映心理社会功能的变量仍然是分配的显著预测因素。
年龄较小是接受更长治疗时间的最显著预测因素，这一发现重复了先前关于人格障碍治疗分配的一项研究结果。总体而言，本研究因此进一步支持了人口统计学和社会背景因素在临床医生将患者分配到不同人格障碍治疗服务中的重要性。
