Bozzatello Paola, Bellino Silvio
Department of Neuroscience, University of Turin, Turin, Italy.
Front Psychiatry. 2020 Sep 11;11:578910. doi: 10.3389/fpsyt.2020.578910. eCollection 2020.
Recent guidelines share the recommendations that psychotherapy plays a central role in the treatment of borderline personality disorder (BPD). In recent years, interpersonal psychotherapy adapted for treating BPD (IPT-BPD) was added to specific psychotherapies and was tested in combination with pharmacotherapy. The present study is aimed to assess the efficacy of IPT-BPD revised (IPT-BPD-R) as single treatment in a sample of BPD patients. Results obtained in a group of patients receiving IPT-BPD-R were compared with those observed in a control group in waiting list plus clinical management (WL/CM). Forty-three BPD subjects were randomly allocated to one of the two arms. Patients were assessed at baseline and after 10 months with the following assessment instruments: Clinical Global Impression Scale, Severity item (CGI-S), Social Occupational Functioning Assessment Scale (SOFAS), Borderline Personality Disorder Severity Index (BPDSI), Barratt Impulsiveness Scale, version 11 (BIS-11), Modified Overt Aggression Scale (MOAS), and Self Harm Inventory (SHI). Statistical analysis was performed with one-way analysis of variance (ANOVA) or chi-square test to compare baseline characteristics of the two treatment groups. Comparison of score changes at the end of the trial between the two groups was calculated for each rating scale with the analysis of variance for repeated measures. Seven patients (16.3%) discontinued the treatment in the first month of the trial for non-adherence. We found a significant effect within subjects (trial duration) for all rating scales, except for the MOAS. A significant effect between subjects (treatment modality) was found for CGI-S; SOFAS; BIS-11 total score and subscale "non-planning impulsivity"; BPDSI total score and items "interpersonal relationships," "impulsivity," and "identity." So, results showed differences between groups in favor of psychotherapy in terms of reduction of severity of general psychopathology, improvement of social and occupational functioning, and decrease of global BPD symptoms and three specific domains. On the other hand, we did not find any differences between groups for self-harm behaviors and aggressive behaviors.
近期指南一致推荐心理治疗在边缘型人格障碍(BPD)的治疗中发挥核心作用。近年来,适用于治疗BPD的人际心理治疗(IPT - BPD)被纳入特定心理治疗方法,并与药物治疗联合进行了测试。本研究旨在评估修订后的IPT - BPD(IPT - BPD - R)作为单一治疗方法对BPD患者样本的疗效。将接受IPT - BPD - R治疗的一组患者的结果与等待名单加临床管理(WL/CM)对照组中观察到的结果进行比较。43名BPD受试者被随机分配到两个组之一。在基线时以及10个月后,使用以下评估工具对患者进行评估:临床总体印象量表严重程度项目(CGI - S)、社会职业功能评估量表(SOFAS)、边缘型人格障碍严重程度指数(BPDSI)、巴拉特冲动性量表第11版(BIS - 11)、改良外显攻击量表(MOAS)和自我伤害量表(SHI)。采用单因素方差分析(ANOVA)或卡方检验进行统计分析,以比较两个治疗组的基线特征。使用重复测量方差分析为每个评定量表计算两组在试验结束时得分变化的比较。7名患者(16.3%)在试验的第一个月因不依从而停止治疗。我们发现,除MOAS外,所有评定量表在受试者内部(试验持续时间)均有显著效果。在受试者之间(治疗方式),CGI - S、SOFAS、BIS - 11总分及“非计划性冲动性”子量表、BPDSI总分及“人际关系”“冲动性”和“身份认同”项目有显著效果。因此,结果显示在减轻一般精神病理学严重程度、改善社会和职业功能以及降低总体BPD症状和三个特定领域方面,两组之间存在有利于心理治疗的差异。另一方面,我们未发现两组在自我伤害行为和攻击行为方面存在任何差异。