Center for Dependency Disorders, Stockholm County Council, Stockholm, Sweden.
Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Eur Addict Res. 2018;24(1):1-8. doi: 10.1159/000485564. Epub 2018 Jan 19.
There is a scarcity of clinical trials on psychological treatments for concurrent borderline personality disorder (BPD) and substance use disorder (SUD). Mentalization-based treatment (MBT) have shown efficacy in several trials on BPD. The aim of the present study was to examine the feasibility and effectiveness of MBT for concurrent BPD and SUD.
Patients (n = 46) with concurrent BPD and SUD were randomized either to MBT in combination with SUD treatment (n = 24) or to SUD treatment alone (n = 22). Outcome was measured after 18 months using objective data, as well as interview and self-report measures.
There was no significant difference between the groups on any outcome variable. No suicide attempts occurred in the MBT group in contrast to 4 suicide attempts that occurred in the control group - a difference that did not reach statistical significance (p = 0.06). A majority of the therapists did not show sufficient MBT adherence and quality.
MBT for patients with concurrent BPD and SD does not appear to be harmful; on the other hand, it is possibly helpful in reducing the risk involved in suicide attempts.
同时患有边缘型人格障碍（BPD）和物质使用障碍（SUD）的患者，其心理治疗的临床试验相对较少。基于心理化的治疗（MBT）在几项 BPD 试验中已显示出疗效。本研究旨在探讨 MBT 对同时患有 BPD 和 SUD 的患者的可行性和有效性。
同时患有 BPD 和 SUD 的患者（n=46）被随机分为 MBT 联合 SUD 治疗组（n=24）或 SUD 单独治疗组（n=22）。18 个月后，使用客观数据、访谈和自我报告测量来评估结果。
两组在任何结果变量上均无显著差异。MBT 组无自杀企图，而对照组有 4 例自杀企图，但差异无统计学意义（p=0.06）。大多数治疗师的 MBT 依从性和质量都不高。
对于同时患有 BPD 和 SUD 的患者，MBT 似乎没有害处；另一方面，它可能有助于降低自杀企图的风险。
