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简短辩证行为疗法干预对边缘型人格障碍/特质成年人的可行性与疗效:一项系统评价

Feasibility and Efficacy of Brief DBT Intervention for Adults With Borderline Personality Disorder/Traits: A Systematic Review.

作者信息

Zhang Yujie, Chen Spencer X, Smit Martina, Chapman Alexander L

机构信息

Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.

Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada.

出版信息

Personal Ment Health. 2025 Nov;19(4):e70034. doi: 10.1002/pmh.70034.

Abstract

Standard, comprehensive dialectical behavioral therapy (DBT) has been well established as an effective and evidence-based treatment for borderline personality disorder (BPD). As a comprehensive and longer term treatment (e.g., 6-12 months or more), DBT can be challenging to implement in resource-strapped public healthcare settings. The purpose of this systematic review was to examine existing literature to assess the efficacy and feasibility of abbreviated DBT programs (16 weeks or fewer in duration, no more than one group session per week). Literature searches yielded 22 studies (20 journal articles and 2 dissertations) meeting criteria for inclusion. Findings indicated that abbreviated forms of DBT are overall effective in improving symptoms of BPD, general psychiatric symptoms including depression and anxiety, and general functioning. Attrition rates varied widely (between 0% and 60%). Of note, the majority of studies reviewed were observational, had small sample sizes, and used varied outcome measures focusing on preintervention and postintervention symptom scores. In this article, we discuss the current state of the literature and suggest future directions for the efficient implementation of DBT.

摘要

标准的综合性辩证行为疗法(DBT)已被充分确立为治疗边缘型人格障碍(BPD)的一种有效且基于证据的疗法。作为一种综合性的长期治疗方法(例如6至12个月或更长时间),在资源匮乏的公共医疗环境中实施DBT可能具有挑战性。本系统评价的目的是审查现有文献,以评估简化版DBT项目(疗程为16周或更短,每周不超过一次团体治疗)的疗效和可行性。文献检索产生了22项符合纳入标准的研究(20篇期刊文章和2篇学位论文)。研究结果表明,简化版DBT总体上在改善BPD症状、包括抑郁和焦虑在内的一般精神症状以及总体功能方面是有效的。脱落率差异很大(在0%至60%之间)。值得注意的是,大多数纳入综述的研究都是观察性的,样本量较小,并且使用了侧重于干预前和干预后症状评分的多种结局测量方法。在本文中,我们讨论了文献的现状,并提出了有效实施DBT的未来方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c93f/12409768/0fdf36b5ecdb/PMH-19-0-g001.jpg

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