OBJECTIVE Dialectical behavior therapy (DBT) is an evidence-based treatment that targets suicidal behavior and nonsuicidal self-injury (NSSI) and has been adapted for adolescents. Given the seriousness of these behaviors, many adolescents are psychiatrically hospitalized, but minimal research has been conducted on specific interventions during hospitalization. The goal of this study was to evaluate DBT versus treatment as usual (TAU) for adolescents on an acute-care psychiatric inpatient unit. METHOD We conducted a retrospective chart review for adolescents receiving inpatient DBT (n = 425) and for a historical control group treated on the same unit before DBT (ie, TAU, n = 376). Both χ2 and t tests were conducted as preliminary analyses to examine differences between groups on diagnosis, sex, and age. Mann-Whitney U tests were conducted to examine differences between groups on outcome variables. The potential benefit of cost savings was analyzed. RESULTS Patients who received DBT had significantly fewer constant observation (CO) hours for self-injury; incidents of suicide attempts and self-injury; restraints; and days hospitalized compared to patients who received TAU. Statistically significant differences were not found between DBT and TAU groups for number of CO hours for aggression, incidents of aggression toward patients or staff, seclusions, or readmissions. A cost analysis determined that $251,609 less was spent on staff time for CO hours with DBT compared to TAU. CONCLUSION Results provide support for the implementation of DBT in an acute-care adolescent psychiatric inpatient unit for adolescents. Clinical implications, study limitations, and future research directions are discussed.

中文翻译：

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辩证行为疗法与常规治疗对住院青少年的有效性。

目的辩证行为疗法（DBT）是一种针对自杀行为和非自杀性自残（NSSI）的循证治疗，已针对青少年进行了调整。鉴于这些行为的严重性，许多青少年都在精神病院住院治疗，但是在住院期间针对具体干预措施的研究很少。这项研究的目的是评估在急诊精神病住院患者中青少年的DBT与常规治疗（TAU）的关系。方法我们对接受住院DBT的青少年（n = 425）和在DBT之前接受相同治疗的历史对照组（即TAU，n = 376）进行了回顾性图表审查。进行χ2和t检验作为初步分析，以检查各组之间在诊断，性别和年龄方面的差异。进行了Mann-Whitney U检验，以检验结果变量之间的组间差异。分析了节省成本的潜在好处。结果接受DBT的患者自伤的持续观察时间（CO）显着减少。自杀未遂和自残事件；约束；与接受TAU的患者相比住院天数。在DBT组和TAU组之间，在侵略性CO时数，侵害患者或医务人员的事件，隐居或再入院方面，未发现统计学上的显着差异。成本分析确定，与TAU相比，DBT的CO员工小时花费的员工时间减少了251,609美元。结论结果为DBT在青少年急诊青少年精神病住院单元中的实施提供了支持。临床意义