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[基于证据的边缘性人格障碍住院心理治疗]

[Evidence-based inpatient psychotherapy in borderline personality disorder].

作者信息

Jörg Christian, Clemm von Hohenberg Christian, Schmahl Christian

机构信息

Klinik für Psychosomatik und Psychotherapeutische Medizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, 68159, Mannheim, Deutschland.

出版信息

Nervenarzt. 2023 Mar;94(3):206-212. doi: 10.1007/s00115-023-01438-y. Epub 2023 Feb 3.

Abstract

BACKGROUND

Borderline personality disorder (BPD) is frequent (prevalence in Germany between 0.7% and 4.5%) [11] and is associated with a high level of psychological stress and frequent emergency inpatient admissions. The provision of disorder-specific outpatient psychotherapy is still insufficient also in Germany.

OBJECTIVE

This article provides an overview of the available data on the effectiveness of inpatient psychotherapy for BPD.

MATERIAL AND METHODS

A qualitative review on the effectiveness and therapy outcome predictors was conducted based on a literature search in PubMed.

RESULTS

Overall, very few randomized controlled trials are available; in contrast uncontrolled studies are predominant. Most evidence is available for dialectical behavior therapy (DBT) but other approaches, including psychodynamic procedures, have also been studied.

DISCUSSION

The currently available data suggest an efficacy of inpatient psychotherapy for BPD; however, randomized trials with larger samples and sufficient representation including male patients are largely lacking. There is also no substantial direct evidence for the superiority of inpatient compared to outpatient psychotherapy.

摘要

背景

边缘型人格障碍(BPD)较为常见(德国患病率在0.7%至4.5%之间)[11],且与高水平的心理压力和频繁的急诊住院相关。在德国,针对该疾病的门诊心理治疗服务仍不足。

目的

本文概述了有关BPD住院心理治疗有效性的现有数据。

材料与方法

基于在PubMed上的文献检索,对有效性和治疗结果预测因素进行了定性综述。

结果

总体而言,可用的随机对照试验非常少;相比之下,非对照研究占主导。关于辩证行为疗法(DBT)的证据最多,但也研究了其他方法,包括心理动力学程序。

讨论

目前可用的数据表明住院心理治疗对BPD有效;然而,大量缺乏样本量更大且包括男性患者在内有充分代表性的随机试验。也没有实质性的直接证据表明住院心理治疗优于门诊心理治疗。

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