Stockholm Health Care Services, Stockholm County Council, Stockholm Psychiatry Southwest, Stockholm, Sweden.
Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Norra stationsgatan 69, 7 tr, 113 64, Stockholm, Sweden.
BMC Psychiatry. 2018 Jun 11;18(1):185. doi: 10.1186/s12888-018-1699-6.
Mentalisation-based treatment (MBT) in borderline personality disorder (BPD) has a growing evidence base, but there is a lack of effectiveness and moderator studies. The present study examined the effectiveness of MBT in a naturalistic setting and explored psychiatric and psychological moderators of outcome.
Borderline and general psychiatric symptoms, suicidality, self-harm, alexithymia and self-image were measured in a group of BPD patients (n = 75) receiving MBT; assessments were made at baseline, and subsequently after 6, 12 and 18 months (when treatment ended). Borderline symptoms were the primary outcome variable.
Borderline symptoms improved significantly (d = 0.79, p < .001), as did general psychiatric symptoms, suicidality, self-harm, self-rated alexithymia and self-image. BPD severity or psychological moderators had no effect on outcome. Younger patients improved more on self-harm, although this could be explained by the fact that older patients had considerably lower baseline self-harm.
MBT seems to be an effective treatment in a naturalistic setting for BPD patients. This study is one of the first studies of MBT showing that outcomes related to mentalisation, self-image and self-rated alexithymia improved. Initial symptom severity did not influence results indicating that MBT treatment is well adapted to patients with severe BPD symptoms.
The study was retrospectively registered 25 September 2017 in the ClinicalTrials.gov PRS registry, no. NCT03295838 .
基于心理化的治疗（MBT）在边缘型人格障碍（BPD）中有越来越多的证据支持，但缺乏有效性和调节因素的研究。本研究在自然环境中检验了 MBT 的有效性，并探讨了精神病学和心理学调节因素对结果的影响。
在接受 MBT 的一组 BPD 患者（n=75）中测量了边缘型和一般精神症状、自杀意念、自残、述情障碍和自我形象；在基线时进行评估，随后在 6、12 和 18 个月（治疗结束时）进行评估。边缘型症状是主要的结果变量。
边缘型症状显著改善（d=0.79，p<0.001），一般精神症状、自杀意念、自残、自我评定的述情障碍和自我形象也得到改善。BPD 严重程度或心理调节因素对结果没有影响。年轻患者在自残方面的改善更大，尽管这可以解释为老年患者的自残基线水平要低得多。
MBT 似乎是一种有效的治疗方法，在自然环境中对 BPD 患者有效。这项研究是首次研究 MBT 的研究之一，表明与心理化、自我形象和自我评定的述情障碍相关的结果得到了改善。初始症状严重程度不影响结果，表明 MBT 治疗很好地适应了严重 BPD 症状的患者。
该研究于 2017 年 9 月 25 日在 ClinicalTrials.gov PRS 注册库中进行了回顾性注册，编号为 NCT03295838。
