Background

People with Borderline Personality Disorder (BPD) have limited access to long term psychological therapies. Briefer interventions have been developed but trial evidence to support their use has not been reviewed.

Aims

To examine whether psychological interventions for adults with BPD of six months duration or less improve symptoms, mood, self-harm, suicidal behaviour, and service use.

Methods

The protocol was prospectively registered (PROSPERO CRD42017063777). Database searches were conducted up to April 2020. Inclusion, data extraction and risk of bias were assessed in duplicate. We identified 27 randomised controlled trials. We conducted random-effects meta-analyses sub-grouping data into delivery method, additional support, and comparison type.

Results

High levels of bias were found for attrition and reporting. Heterogeneity was high in some pooled data. Borderline symptom reductions were greatest for interventions including additional support (SMD. -1.23, 95% C.I. -2.13, −0.33). Planned generic support may be as effective as specialist interventions for borderline symptoms (SMD = −0.11, 95% C.I. -0.51, 0.29) and social functioning (SMD = −0.16., 95% C.I. -0.65, 0.33). Follow-up was limited and direct comparison with post-intervention results was unreliable.

Conclusions

Short-term interventions may be effective. Access to additional support has an impact on outcomes. It is unclear if symptomatic change is sustained.

中文翻译：

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边缘型人格障碍的简短心理干预。随机对照试验的系统评价和荟萃分析

背景

边缘型人格障碍 (BPD) 患者获得长期心理治疗的机会有限。已经制定了更简短的干预措施，但尚未审查支持其使用的试验证据。

宗旨

检查对持续时间不超过 6 个月的 BPD 成年人的心理干预是否能改善症状、情绪、自残、自杀行为和服务使用。

方法

该协议是前瞻性注册的 (PROSPERO CRD42017063777)。数据库搜索一直进行到 2020 年 4 月。纳入、数据提取和偏倚风险进行了重复评估。我们确定了 27 项随机对照试验。我们进行了随机效应荟萃分析，将数据细分为交付方法、额外支持和比较类型。

结果

发现人员流失和报告存在高度偏见。一些汇总数据的异质性很高。包括额外支持在内的干预措施的临界症状减少幅度最大（SMD。-1.23，95% CI -2.13，-0.33）。对于临界症状 (SMD = -0.11, 95% CI -0.51, 0.29) 和社会功能 (SMD = -0.16., 95% CI -0.65, 0.33)，计划的通用支持可能与专家干预一样有效。随访有限，与干预后结果的直接比较是不可靠的。

结论

短期干预可能有效。获得额外支持会对结果产生影响。目前尚不清楚症状变化是否持续。