VA Maryland Health Care System, United States; University of Maryland School of Medicine, United States.
VA Maryland Health Care System, United States.
Eval Program Plann. 2022 Jun;92:102098. doi: 10.1016/j.evalprogplan.2022.102098. Epub 2022 Apr 20.
A comprehensive Dialectical Behavior Therapy (DBT) program was created within a VA Health Care System for patients with recent psychiatric hospitalization, suicidality and/or significant emotion dysregulation. The program was notable for being one of a relatively small number of comprehensive DBT programs in the VA system, and for including patients with psychosis and psychotic disorder, with a majority of patients (58%) having a documented history of psychosis or endorsing psychotic symptoms in assessments. We describe the process of creating this program at a VA medical center and present preliminary program evaluation data. All patients completed assessments of suicidality (C-SSRS), emotion dysregulation (DERS), skills use and dysfunctional coping (DBT-WCCL), borderline symptomatology (BSL-23), and depression (PHQ-9) at program entry and subsequently every 6-8 weeks through program completion. Suicide attempts and hospitalizations were also tracked. Twelve patients completed multiple (up to six) assessment timepoints, allowing for evaluation of change during treatment. Patients demonstrated improvements on most measures and no hospitalizations or suicide attempts during active treatment, and the subsample with psychosis showed average improvements on every outcome measure. Eleven of 12 patients completed a full six-month rotation.
一个综合性辩证行为治疗（DBT）项目在退伍军人医疗保健系统中为最近有精神住院、自杀意念和/或明显情绪失调的患者设立。该项目的显著特点是，它是退伍军人系统中为数不多的综合性 DBT 项目之一，并且包括患有精神病和精神病障碍的患者，其中大多数患者（58%）有精神病病史或在评估中表现出精神病症状。我们描述了在退伍军人医疗中心创建该项目的过程，并提出了初步的项目评估数据。所有患者在项目开始时和随后的每个 6-8 周，直到项目结束时，都完成了自杀意念（C-SSRS）、情绪调节（DERS）、技能使用和功能失调应对（DBT-WCCL）、边缘症状学（BSL-23）和抑郁（PHQ-9）的评估。自杀企图和住院情况也被跟踪。12 名患者完成了多次（最多 6 次）评估时间点，允许评估治疗期间的变化。患者在大多数指标上都有所改善，在积极治疗期间没有住院或自杀企图，并且精神病亚组在每个结果测量上都有平均改善。11 名患者中的 12 名完成了整整六个月的轮换。
