Hernandez-Bustamante Milton, Cjuno Julio, Hernández Ronald M, Ponce-Meza Jacqueline C
Universidad Peruana Unión, Lima, Peru.
Universidad Privada Antenor Orrego, Trujillo, Peru.
Iran J Psychiatry. 2024 Jan;19(1):119-129. doi: 10.18502/ijps.v19i1.14347.
Borderline personality disorder (BPD) is a serious public health problem. Dialectical Behavior Therapy (DBT) is a program that has provided encouraging results for its treatment. However, scientific evidence about its efficacy is scarce. Therefore, we aimed to describe the scientific production on the components of the DBT program and its therapeutic efficacy in the treatment of people with BPD. A systematic review with relevant keywords was conducted based on studies available in Scopus, Web of Science, and PubMed until June 2023, including studies in English, research on therapeutic intervention, studies with a randomized controlled trial (RCT) design that included people with the diagnosis of BPD. We found 18 RCTs, most of which supported the effectiveness of DBT for BPD. There were a total of 1,755 participants in these studies, most of whom were women. These studies looked for treating self-injurious behaviors, suicidal thoughts or ideations, number of visits to emergency services, and frequency of hospital admissions. Most studies revealed that both short-term DBT and standard DBT improved suicidality in BPD patients with small or moderate effect sizes, lasting up to 24 months after the treatment period. Furthermore, these studies showed that DBT can significantly improve general psychopathology and depressive symptoms in patients with BPD. Improvement of compliance, impulsivity, mood instability, as well as reduction in hospitalization rate are other findings observed in the trials following DBT. Although DBT shows efficacy in the treatment of BPD, heterogeneity in the methodologies employed is highlighted. Therefore, it is necessary to design studies from a homogeneous theoretical and methodological framework.
边缘性人格障碍（BPD）是一个严重的公共卫生问题。辩证行为疗法（DBT）是一种在其治疗方面取得了令人鼓舞的成果的疗法。然而，关于其疗效的科学证据却很稀少。因此，我们旨在描述关于DBT疗法的组成部分及其在治疗BPD患者中的治疗效果的科学成果。 基于Scopus、科学网和PubMed上截至2023年6月的现有研究，使用相关关键词进行了一项系统综述，包括英文研究、治疗干预研究、采用随机对照试验（RCT）设计且纳入了被诊断为BPD的患者的研究。我们发现了18项RCT研究，其中大多数支持DBT对BPD的有效性。这些研究共有1755名参与者，其中大多数是女性。这些研究旨在治疗自我伤害行为、自杀念头或想法、急诊就诊次数以及住院频率。大多数研究表明，短期DBT和标准DBT都能改善BPD患者的自杀倾向，效应量小或中等，在治疗期后可持续长达24个月。此外，这些研究表明，DBT可以显著改善BPD患者的一般精神病理学和抑郁症状。在接受DBT治疗的试验中还观察到了依从性、冲动性、情绪不稳定的改善以及住院率的降低等其他结果。 尽管DBT在治疗BPD方面显示出疗效，但所采用的方法存在异质性。因此，有必要从一个统一的理论和方法框架来设计研究。
