University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
Psychother Psychosom. 2023;92(4):243-254. doi: 10.1159/000531092. Epub 2023 Jul 24.
The "Cutting Down Programme" (CDP), a brief psychotherapeutic intervention for treating nonsuicidal self-injury (NSSI) in adolescents, was comparable to high-quality treatment as usual (TAU) in a previous randomized controlled trial (RCT).
The aim of the study was to evaluate the long-term outcomes of the CDP over up to 4 years.
Assessments of NSSI, suicide attempts, borderline personality disorder (BPD), depression, and quality of life took place 2 to 4 years (T3) after enrollment in a RCT. The evolution of NSSI, suicide attempts, depression, and quality of life was analyzed using (generalized) linear mixed-effects models. Ordered logistic regression was used for analyzing BPD diagnoses. Data from T0, T2, and T3 are reported.
Out of 74 patients, 70 (95%) were included in the T3 assessment. The frequency of NSSI events alongside with suicide attempts and depression further decreased between T2 and T3 and BPD between T0 and T3 in both groups. Quality of life remained stable in both groups between T2 and T3. Both groups received substantial but comparable additional treatment between T2 and T3. More treatment sessions during the follow-up period were linked to larger improvements of NSSI.
The CDP was found to be as effective as TAU in promoting recovery from NSSI and comorbid symptoms in the long term. Results suggest that treatment effects from a brief psychotherapeutic intervention may endure and even further improve after completion of the program. However, additional treatment seems to improve chances for recovery independent from CDP versus TAU.
“削减计划”（CDP）是一种针对青少年非自杀性自我伤害（NSSI）的简短心理治疗干预措施，在之前的一项随机对照试验（RCT）中与高质量的常规治疗（TAU）相当。
本研究旨在评估 CDP 在长达 4 年的时间内的长期效果。
在 RCT 入组后 2 至 4 年（T3）评估 NSSI、自杀企图、边缘型人格障碍（BPD）、抑郁和生活质量。使用（广义）线性混合效应模型分析 NSSI、自杀企图、抑郁和生活质量的演变。使用有序逻辑回归分析 BPD 诊断。报告了 T0、T2 和 T3 的数据。
在 74 名患者中，有 70 名（95%）患者纳入了 T3 评估。两组的 NSSI 事件、自杀企图和抑郁的频率在 T2 和 T3 之间进一步减少，BPD 在 T0 和 T3 之间也减少。两组的生活质量在 T2 和 T3 之间保持稳定。两组在 T2 和 T3 之间都接受了大量但相当的额外治疗。随访期间接受的治疗次数越多，NSSI 的改善越大。
CDP 在促进 NSSI 和共病症状的长期恢复方面被发现与 TAU 一样有效。结果表明，简短心理治疗干预的治疗效果可能在完成治疗后持续存在，甚至进一步改善。然而，额外的治疗似乎可以提高恢复的机会，而与 CDP 或 TAU 无关。
