School of Psychology, Trinity College, Dublin, Ireland.
School of Psychology, Bangor University, Bangor, UK.
Early Interv Psychiatry. 2020 Feb;14(1):61-68. doi: 10.1111/eip.12808. Epub 2019 May 1.
Targeting young adults with borderline personality disorder (BPD) for treatment may carry significant social and clinical benefits. We aimed to evaluate a community-based Dialectical Behaviour Therapy (DBT) programme delivered exclusively to young adults with BPD.
We describe a naturally occurring non-equivalent, quasi-experimental comparison of outcomes for young adults (18-25 years) with BPD following 1 year of treatment in either a young adult only DBT programme or a general adult DBT programme (18+ years). Twenty-four young adults enrolled in a community-based young adult DBT programme open only to 18- to 25-year-olds with BPD. Another 13 young adults, also 18-25 years, enrolled in a general adult DBT programme open to all ages above 18 years. Both treatment conditions offered all modes of standard DBT for 1 year. Participants completed a battery of self-report measures on mental health symptoms at baseline and again at treatment completion after 1 year. Discharge rates at 2 years post-treatment completion were also recorded.
Better outcomes were found on borderline symptom severity and general psychopathology among completers of young adult DBT, with a large effect size for treatment condition as well as greater clinically significant change. Discharge rates from mental health services 24 months later were also higher for completers of young adult DBT.
There may be advantages in delivering DBT to young adults in an age-specific programme, possibly due to group cohesion. Methodological limitations apply, such as small sample size and non-randomization. Further controlled research is needed.
针对边缘型人格障碍(BPD)的年轻患者进行治疗可能具有重要的社会和临床效益。我们旨在评估一种专门针对年轻 BPD 患者的基于社区的辩证行为疗法(DBT)项目。
我们描述了一种自然发生的、非等效的、准实验性比较,比较了在接受为期 1 年的青年 DBT 项目或一般成人 DBT 项目(18 岁以上)治疗后,18-25 岁的 BPD 年轻患者的结局。24 名年轻患者参加了一个只对 18-25 岁的 BPD 患者开放的基于社区的青年 DBT 项目。另有 13 名年轻患者,年龄也在 18-25 岁之间,参加了一个向所有 18 岁以上年龄的人开放的一般成人 DBT 项目。两种治疗条件都提供了为期 1 年的标准 DBT 的所有模式。参与者在基线和 1 年后的治疗完成时完成了一套心理健康症状的自我报告措施。在治疗完成后 2 年也记录了出院率。
青年 DBT 完成者的边缘症状严重程度和一般精神病学症状有更好的结果,治疗条件的效果大小较大,且具有更大的临床显著变化。青年 DBT 完成者在 24 个月后的心理健康服务出院率也更高。
在特定年龄的项目中为年轻人提供 DBT 可能具有优势,这可能是由于团体凝聚力。但方法学上存在局限性,如样本量小和非随机化。需要进一步的对照研究。