Ilagan Gabrielle S, Iliakis Evan A, Wilks Chelsey R, Vahia Ipsit V, Choi-Kain Lois W
McLean Hospital, 115 Mill St, Belmont, MA 02478 USA.
Harvard University, Cambridge, USA.
Borderline Personal Disord Emot Dysregul. 2020 Jun 16;7:12. doi: 10.1186/s40479-020-00127-5. eCollection 2020.
Smartphone applications could improve symptoms of borderline personality disorder (BPD) in a scalable and resource-efficient manner in the context limited access to specialized care.
This systematic review and meta-analysis aims to evaluate the effectiveness of applications designed as treatment interventions for adults with symptoms such as anger, suicidality, or self-harm that commonly occur in BPD.
Search terms for BPD symptoms, smartphone applications, and treatment interventions were combined on PubMed, MEDLINE, and PsycINFO from database inception to December 2019.
Controlled and uncontrolled studies of smartphone interventions for adult participants with symptoms such as anger, suicidality, or self-harm that commonly occur in BPD were included.
was used to compute between-groups effect sizes in controlled designs. The primary outcome was BPD-related symptoms such as anger, suicidality, and impulsivity; and the secondary outcome was general psychopathology. An average dropout rate across interventions was computed. Study quality, target audiences, therapeutic approach and targets, effectiveness, intended use, usability metrics, availability on market, and downloads were assessed qualitatively from the papers and through internet search.
Twelve studies of 10 applications were included, reporting data from 408 participants. Between-groups meta-analyses of RCTs revealed no significant effect of smartphone applications above and beyond in-person treatments or a waitlist on BPD symptoms (Hedges' = - 0.066, 95% CI [-.257, .125]), nor on general psychopathology (Hedges' = 0.305, 95% CI [- 0.14, 0.75]). Across the 12 trials, dropout rates ranged from 0 to 56.7% ( = 22.5, 95% CI [0.15, 0.46]). A majority of interventions studied targeted emotion dysregulation and behavioral dyscontrol symptoms. Half of the applications are commercially available.
The effects of smartphone interventions on symptoms of BPD are unclear and there is currently a lack of evidence for their effectiveness. More research is needed to build on these preliminary findings in BPD to investigate both positive and adverse effects of smartphone applications and identify the role these technologies may provide in expanding mental healthcare resources.
在获得专业护理机会有限的情况下，智能手机应用程序可以以可扩展且资源高效的方式改善边缘型人格障碍（BPD）的症状。
本系统评价和荟萃分析旨在评估设计用于治疗有愤怒、自杀观念或自伤等常见于BPD症状的成年人的应用程序的有效性。
从数据库建立至2019年12月，在PubMed、MEDLINE和PsycINFO上组合了关于BPD症状、智能手机应用程序和治疗干预的检索词。
纳入了针对有愤怒、自杀观念或自伤等常见于BPD症状的成年参与者的智能手机干预的对照和非对照研究。
用于计算对照设计中的组间效应量。主要结局是与BPD相关的症状，如愤怒、自杀观念和冲动性；次要结局是一般精神病理学。计算了各干预措施的平均退出率。从论文和通过互联网搜索对研究质量、目标受众、治疗方法和靶点、有效性、预期用途、可用性指标、市场上的可获得性和下载量进行了定性评估。
纳入了10个应用程序的12项研究，报告了408名参与者的数据。随机对照试验的组间荟萃分析显示，智能手机应用程序在BPD症状方面，相较于面对面治疗或等待名单，没有显著效果（Hedges' = -0.066，95%可信区间[-0.257, 0.125]），在一般精神病理学方面也没有显著效果（Hedges' = 0.305，95%可信区间[-0.14, 0.75]）。在这12项试验中，退出率范围为0至56.7%（= 22.5，95%可信区间[0.15, 0.46]）。大多数研究的干预措施针对情绪失调和行为失控症状。一半的应用程序可在商业上获得。
智能手机干预对BPD症状的影响尚不清楚，目前缺乏其有效性的证据。需要更多研究以这些关于BPD的初步发现为基础，来调查智能手机应用程序的正面和负面影响，并确定这些技术在扩大精神卫生保健资源方面可能发挥的作用。
