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评估辩证行为疗法(DBT)疗效的荟萃分析与系统评价

Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT).

作者信息

Panos Patrick T, Jackson John W, Hasan Omar, Panos Angelea

机构信息

University of Utah, Salt Lake City, UT, USA.

Harvard University, Boston, MA, USA.

出版信息

Res Soc Work Pract. 2014 Mar;24(2):213-223. doi: 10.1177/1049731513503047. Epub 2013 Sep 19.

Abstract

OBJECTIVE

The objective was to quantitatively and qualitatively examine the efficacy of DBT (e.g., decreasing life-threatening suicidal and parasuicidal acts, attrition, and depression) explicitly with borderline personality disorder (BPD) and using conservative assumptions and criteria, across treatment providers and settings.

METHOD

Five randomized controlled trials (RCTs) were identified in a systematic search that examined the efficacy of DBT in reducing suicide attempts, parasuicidal behavior, attrition during treatment, or symptoms of depression, in adult patients with BPD.

RESULTS

Combining effect measures for suicide and parasuicidal behavior (five studies total) revealed a net benefit in favor of DBT (pooled Hedges' -0.622). DBT was only marginally better than treatment as usual (TAU) in reducing attrition during treatment in five RCTs (pooled risk difference -0.168). DBT was not significantly different from TAU in reducing depression symptoms in three RCTs (pooled Hedges' -0.896).

DISCUSSION

DBT demonstrates efficacy in stabilizing and controlling self-destructive behavior and improving patient compliance.

摘要

目的

目的是明确地、定量和定性地检验辩证行为疗法(DBT)(例如,减少危及生命的自杀和准自杀行为、治疗中断和抑郁)在边缘性人格障碍(BPD)患者中的疗效,并在不同治疗提供者和环境中采用保守的假设和标准。

方法

在一项系统检索中识别出五项随机对照试验(RCT),这些试验考察了DBT在减少成年BPD患者自杀企图、准自杀行为、治疗期间的治疗中断或抑郁症状方面的疗效。

结果

综合自杀和准自杀行为的效应量(共五项研究)显示DBT有净益处(合并的海奇斯g值为-0.622)。在五项RCT中,DBT在减少治疗期间的治疗中断方面仅略优于常规治疗(TAU)(合并风险差为-0.168)。在三项RCT中,DBT在减少抑郁症状方面与TAU无显著差异(合并的海奇斯g值为-0.896)。

讨论

DBT在稳定和控制自我毁灭行为以及提高患者依从性方面显示出疗效。

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