García María Cecilia
Hospital Aeronáutico Central. Jefa de Residentes en Hospital Militar Campo de Mayo. Vicepresidenta del Capítulo de Juego Patológico y otras Adicciones Conductuales de APSA. Miembro permanente en el Capítulo de Psicotrauma de APSA. E-mail:
Vertex. 2020 Apr;XXX(148):1-10. doi: 10.53680/vertex.v30i148.122.
Recent theory has proposed that a dysfunction of the opioid system modulates mood, reward and pain; seems to be unstable in people with Borderline Personality Disorder. Our purpose is to analyze the evidence on the efficacy of the use of buprenorphine, nalmefene, naloxone and naltrexone, in the treatment of dissociative symptoms, self-mutilation and suicidal behavior of these patients.
We conducted a systematic search of MEDLINE and LILACS databases, to retrieve relevant articles. Included studies were experimental and observational designs of borderline personality samples in which dissociative symptoms, self mutilation or suicidal behavior was reported as an outcome and evaluated with some impact measures.
A total of eight studies were reviewed. These provided interesting expectations about posible treatment lines in Borderline Personality Disorder using opioid antagonists. The subgroup most benefited was the one who has analgesia and highest number of diagnostic criteria.
Studies of higher methodological quality are needed, in larger population samples and using control of confounding variables that allow us to estimate a value power calculation, and thus be able to support firm conclusions.
近期理论提出，阿片类系统功能障碍会调节情绪、奖赏和疼痛；在边缘型人格障碍患者中似乎不稳定。我们的目的是分析使用丁丙诺啡、纳美芬、纳洛酮和纳曲酮治疗这些患者的分离症状、自残和自杀行为疗效的证据。
我们对MEDLINE和LILACS数据库进行了系统检索，以检索相关文章。纳入的研究为边缘型人格样本的实验性和观察性设计，其中分离症状、自残或自杀行为被报告为结果，并通过一些影响测量方法进行评估。
共审查了八项研究。这些研究对使用阿片类拮抗剂治疗边缘型人格障碍的可能治疗方案提供了有趣的预期。受益最大的亚组是有镇痛作用且诊断标准数量最多的亚组。
需要在更大的人群样本中进行方法学质量更高的研究，并控制混杂变量，以便我们能够估计值功效计算，从而能够支持确凿的结论。
