Chanen Andrew M, Andrewes Holly E, Nicol Katie, Jackson Henry J, Cotton Sue M, Gleeson John, Davey Christopher G, McCutcheon Louise, Perera Sharnel, Rayner Victoria, Betts Jennifer K
Orygen, 35 Poplar Rd, Parkville, VIC, 3052, Australia.
Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Rd, Parkville, VIC, 3052, Australia.
Eur Child Adolesc Psychiatry. 2025 May 28. doi: 10.1007/s00787-025-02742-5.
No studies have investigated baseline predictors of functioning among young people receiving treatment for BPD. The current study aimed to identify the baseline demographic, psychopathological and treatment correlates of interpersonal problems and social adjustment at 12-month follow-up among young people with BPD, who received early intervention in the Monitoring Outcomes of BPD in Youth (MOBY) randomised controlled trial. Of 139 randomised young people (aged 15 to 25 years) who completed interview and self-report measures at baseline (pre-treatment), 98 (M = 18.7, SD = 2.7) provided data on the same measures at 12 months (primary endpoint). Adjusting for other demographic, clinical and treatment characteristics, hierarchical regression analyses revealed that fewer interpersonal problems at 12 months were predicted by fewer interpersonal problems (β = 0.41, p = 0.02), fewer co-occurring personality disorder diagnoses (β = -0.31, p = 0.04), and lower BPD severity (β = -0.31, p = 0.04) at baseline (F = 0.52). Higher social adjustment score at 12 months was predicted by having at least one caregiver engaged in employment at baseline (β = -0.25, p = 0.04, F = 0.41). These findings suggest that young people presenting with lower severity of BPD, fewer interpersonal problems at baseline, and at least one caregiver in employment are more likely to have better functional outcomes following early intervention. Suicide attempts (SA) and self-harm (SH) were not found to be predictors of functional outcome, suggesting that early intervention programs reconsider the disproportionate influence of SA and SH upon decisions about entry or exclusion into treatment programs or clinical trials. Future research should focus upon individual or household indicators of social disadvantage as moderators of outcome in early intervention for BPD.
尚无研究调查接受边缘型人格障碍（BPD）治疗的年轻人功能的基线预测因素。本研究旨在确定在“青少年BPD监测结果”（MOBY）随机对照试验中接受早期干预的BPD青少年在12个月随访时人际问题和社会适应的基线人口统计学、心理病理学及治疗相关因素。在139名随机分组的年轻人（年龄15至25岁）中，有98人（M = 18.7，SD = 2.7）在基线（治疗前）完成了访谈和自我报告测量，并在12个月（主要终点）提供了相同测量的数据。在对其他人口统计学、临床和治疗特征进行调整后，分层回归分析显示，基线时人际问题较少（β = 0.41，p = 0.02）、共病性人格障碍诊断较少（β = -0.31，p = 0.04）以及BPD严重程度较低（β = -0.31，p = 0.04）可预测12个月时人际问题较少（F = 0.52）。基线时有至少一名照顾者就业可预测12个月时社会适应得分较高（β = -0.25，p = 0.04，F = 0.41）。这些发现表明，BPD严重程度较低、基线人际问题较少且至少有一名照顾者就业的年轻人在早期干预后更有可能获得更好的功能结局。自杀未遂（SA）和自我伤害（SH）未被发现是功能结局的预测因素，这表明早期干预项目应重新考虑SA和SH在治疗项目或临床试验入选或排除决策中的过度影响。未来研究应关注社会劣势的个体或家庭指标，将其作为BPD早期干预结局的调节因素。
