van der Boom Bram, Boumparis Nikolaos, Donker Tara, de Beurs Derek, Arntz Arnoud, Riper Heleen
Clinical Psychology Section, Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, De Boelelaan 1105, 1081 HV Amsterdam, Netherlands.
Amsterdam Public Health Research Institute, PO Box 7057, 1007 MB Amsterdam, Netherlands.
Internet Interv. 2022 Apr 1;28:100525. doi: 10.1016/j.invent.2022.100525. eCollection 2022 Apr.
Personality disorders (PDs) form a substantial part of the mental health disease burden. Effective therapies to treat PDs exist, but they are time-consuming, costly, and difficult to scale up. Delivery through the internet could facilitate the scalability of effective treatment methods.
This review summarizes existing evidence on internet-delivered psychotherapy for personality disorders.
Because few randomized controlled trials (RCTs) have been carried out, we conducted a scoping review. We performed a systematic literature search in PubMed, Embase, MEDLINE, CINAHL, PsycInfo, and Cochrane. Studies were selected if they conveyed research findings on internet-delivered PD interventions.
Eleven studies were included. The majority ( = 8) focused specifically on borderline personality disorder (BPD) and the other three on PD in general. The most frequently used form of intervention ( = 7) was the addition of a mobile app to a conventional evidence-based face-to-face treatment such as dialectical behavioral therapy (DBT). Most interventions ( = 8) were still in the development and piloting phase; only two RCTs were found. Usability and patient satisfaction were moderate to high in all studies. Three studies demonstrated significant decreases in borderline personality disorder symptoms.The majority of the studies found were pilot or feasibility studies, most involving mobile apps offered in addition to face-to-face treatment. The add-ons were rated feasible, acceptable, and useful by patients. Reported challenges involved technical difficulties such as programming errors and bugs. Only 45% of the included studies reported on changes in PD symptoms, all showing reduction of symptoms and absence of adverse effects.
This scoping review found that internet interventions for PD are still under-researched, although initial outcomes show promise. The outcomes also encourage future research in terms of developing internet interventions as an add-on to existing treatments, as well as working toward the creation and testing of more encompassing internet-delivered treatments for PD.
人格障碍（PDs）构成了精神健康疾病负担的很大一部分。治疗人格障碍的有效疗法确实存在，但它们耗时、成本高且难以扩大规模。通过互联网提供治疗可以促进有效治疗方法的可扩展性。
本综述总结了关于通过互联网提供的人格障碍心理治疗的现有证据。
由于进行的随机对照试验（RCTs）较少，我们进行了一项范围综述。我们在PubMed、Embase、MEDLINE、CINAHL、PsycInfo和Cochrane中进行了系统的文献检索。如果研究传达了关于通过互联网提供的人格障碍干预措施的研究结果，则将其纳入。
纳入了11项研究。大多数研究（n = 8）专门关注边缘型人格障碍（BPD），另外三项研究则总体关注人格障碍。最常用的干预形式（n = 7）是在传统的循证面对面治疗（如辩证行为疗法（DBT））中添加移动应用程序。大多数干预措施（n = 8）仍处于开发和试点阶段；仅发现两项随机对照试验。在所有研究中，可用性和患者满意度为中度至高。三项研究表明边缘型人格障碍症状有显著减轻。所发现的大多数研究是试点或可行性研究，大多数涉及除面对面治疗外还提供的移动应用程序。患者对这些附加组件的评价是可行、可接受且有用的。报告的挑战包括技术困难，如编程错误和漏洞。纳入研究中只有45%报告了人格障碍症状的变化，所有这些研究均显示症状减轻且无不良反应。
本范围综述发现，尽管初步结果显示出前景，但针对人格障碍的互联网干预措施仍研究不足。这些结果也鼓励未来在将互联网干预措施作为现有治疗的附加组件进行开发方面开展研究，并致力于创建和测试更全面的通过互联网提供的人格障碍治疗方法。
