Geneva University Hospitals, Service d'addictologie HUG, Rue de Grand-Pré 70c, 1202, Genève, Switzerland.
Department of Psychiatry, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland.
Subst Abuse Treat Prev Policy. 2018 Feb 26;13(1):10. doi: 10.1186/s13011-018-0145-6.
Dual diagnosis is common in Borderline Personality Disorder (BPD), one of the most common being Substance Use Disorder (SUD). Previous studies have shown that general psychiatric management (GPM) was effective in reducing borderline symptoms. In the present study, we tested whether the short GPM was as effective in the BPD + SUD as in the BPD group.
We analysed a group of 99 patients presenting a BPD. 51 of these patients presented a SUD. The BPD group and the BPD + SUD group received a manual-based short variant of the GPM treatment. Previous studies have shown that a 10-session version of GPM was effective in reducing borderline symptoms at the end of the treatment (Psychother Psychosom 83:176-86, 2014).
We found no significant difference in the reduction of general symptoms, which diminished in both groups. The specific borderline symptoms were also reduced in both groups, but there was a slightly higher reduction of the borderline symptoms in the SUD group. The therapeutic alliance progressed positively in all groups. Moreover, the alliance increased more over time in the SUD group.
The short variant of GPM seems to be effective in BPD treatment independently from the presence of SUD. Therefore, this treatment could be an effective entry-level treatment for patients with dual diagnosis as well as patients with BPD only. Further studies are needed to confirm efficacy and long-term outcome.
The trial was registered at ClinicalTrial.gov (identifier NCT01896024 ).
双相障碍在边缘型人格障碍（BPD）中很常见，其中最常见的是物质使用障碍（SUD）。先前的研究表明，一般精神病学管理（GPM）在减轻边缘症状方面是有效的。在本研究中，我们测试了短期 GPM 在 BPD+SUD 中的效果是否与 BPD 组一样。
我们分析了一组 99 名患有 BPD 的患者。其中 51 名患者患有 SUD。BPD 组和 BPD+SUD 组接受了基于手册的 GPM 短期变体治疗。先前的研究表明，10 节版本的 GPM 在治疗结束时有效减少了边缘症状（Psychother Psychosom 83:176-86, 2014）。
我们发现两组的一般症状都有显著减轻，但两组之间没有显著差异。两组的特定边缘症状也有所减轻，但 SUD 组的边缘症状减轻幅度略高。治疗联盟在所有组中都得到了积极的发展。此外，SUD 组的联盟随着时间的推移增加得更多。
GPM 的短期变体似乎对 BPD 治疗有效，无论是否存在 SUD。因此，这种治疗可能是双相诊断患者以及仅患有 BPD 患者的有效入门级治疗。需要进一步的研究来确认疗效和长期结果。
该试验在 ClinicalTrial.gov 注册（标识符 NCT01896024）。
