Child and Adolescent Psychiatric Research Department.
Department of Child and Adolescent Psychiatry.
Personal Disord. 2023 Mar;14(2):148-160. doi: 10.1037/per0000572. Epub 2022 May 19.
Borderline personality disorder (BPD) is among the most severe mental health problems with long-lasting deterioration of functioning. According to a Cochrane review, evidence for methods focused on treatment for adolescent BPD patients is very limited. Aims of the study were to demonstrate the noninferiority of adolescent identity treatment (AIT) compared with dialectical behavior therapy for adolescents (DBT-A), and that intensive early treatment of BPD leads to significant improvement of psychosocial and personality functioning in adolescent patients. In a nonrandomized controlled trial using a noninferiority approach, we compared 37 patients treated with DBT-A with 23 patients treated with AIT. Both treatments included 25 weekly individual psychotherapy sessions and five to eight family sessions. Patients were assessed at four timepoints: baseline, posttreatment, 1- and 2-year follow-up. Primary outcome was psychosocial functioning at 1-year follow-up. We performed both intention-to-treat analyses and per-protocol analyses (completers). Baseline characteristics of both groups were not significantly different except for age and self-injurious behavior. In all, six AIT patients (26%) and 10 DBT-A patients (27%) dropped out of treatment. Both DBT-A and AIT significantly improved adolescents' psychosocial functioning (AIT: = 1.82; DBT-A: = 1.73) and personality functioning. BPD criteria and depression were significantly reduced by both treatments. Overall, AIT was found to be not inferior to DBT-A and even more efficient in reducing BPD criteria. Both treatments are highly effective in improving psychosocial functioning and personality functioning in adolescent BPD patients. AIT is a promising approach and not inferior to DBT-A in respect to treatment efficiency. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
边缘型人格障碍（BPD）是最严重的精神健康问题之一，其功能会长期恶化。根据一项 Cochrane 综述，针对青少年 BPD 患者的治疗方法的证据非常有限。本研究旨在证明青少年认同治疗（AIT）与青少年辩证行为治疗（DBT-A）相比不劣效，并且早期强化治疗 BPD 可显著改善青少年患者的心理社会和人格功能。在一项使用非劣效性方法的非随机对照试验中，我们比较了 37 名接受 DBT-A 治疗的患者和 23 名接受 AIT 治疗的患者。两种治疗均包括 25 次每周个体心理治疗和 5 至 8 次家庭治疗。患者在四个时间点进行评估：基线、治疗后、1 年和 2 年随访。主要结局是 1 年随访时的心理社会功能。我们进行了意向治疗分析和方案分析（完成者）。两组患者的基线特征除年龄和自伤行为外无显著差异。共有 6 名 AIT 患者（26%）和 10 名 DBT-A 患者（27%）退出治疗。DBT-A 和 AIT 均显著改善了青少年的心理社会功能（AIT： = 1.82；DBT-A： = 1.73）和人格功能。两种治疗均显著降低了 BPD 标准和抑郁症状。总体而言，AIT 被发现不劣于 DBT-A，甚至在降低 BPD 标准方面更有效。两种治疗方法均能有效提高青少年 BPD 患者的心理社会功能和人格功能。AIT 是一种有前途的方法，在治疗效率方面不劣于 DBT-A。（PsycInfo 数据库记录（c）2023 APA，保留所有权利）。
