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Mentalization-based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial.
Journal of Child Psychology and Psychiatry ( IF 7.6 ) Pub Date : 2019-11-08 , DOI: 10.1111/jcpp.13152
Emma Beck 1, 2, 3 , Sune Bo 1, 2 , Mie Sedoc Jørgensen 1, 2, 4 , Matthias Gondan 3 , Stig Poulsen 3 , Ole Jakob Storebø 1, 2, 5 , Christian Fjellerad Andersen 2 , Espen Folmo 6 , Carla Sharp 7, 8 , Jesper Pedersen 2 , Erik Simonsen 1, 4
Affiliation  

BACKGROUND Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence-based psychotherapeutic programs, including mentalization-based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT-G) for adolescent BPD. METHOD A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms ≥4 DSM-5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1-year MBT-G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS-C); secondary outcomes included self-harm, depression, externalizing and internalizing symptoms (all self-report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326. RESULTS At EOT, the primary outcome was 71.3 (SD = 15.0) in the MBT-G group and 71.3 (SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS-C units in favor of MBT-G, 95% confidence interval -6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group. CONCLUSIONS There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed.

中文翻译:

边缘型人格障碍青少年群体基于心理化的治疗:一项随机对照试验。

背景边缘型人格障碍(BPD)通常在青春期发病,并预示着成年后的功能障碍。高度结构化的循证心理治疗计划,包括基于心理化的治疗 (MBT),是首选治疗方法。MBT 对 BPD 的疗效主要在成人身上进行了测试,没有 RCT 研究过 MBT​​ 组 (MBT-G) 对青少年 BPD 的有效性。方法 共有 112 名青少年(111 名女性)患有 BPD (106) 或 BPD 症状≥4 DSM-5 标准 (5) 转诊至儿童和青少年精神科门诊,被随机分配到 1 年 MBT-G,包括三个介绍性、心理教育课程、37 次每周小组课程、5 次个人案例制定课程和 6 次护理人员小组课程,或像往常一样治疗 (TAU),每月至少进行 12 次单独治疗。主要结果是儿童边缘人格特征量表(BPFS-C)的得分;次要结果包括自我伤害、抑郁、外化和内化症状(所有自我报告)、照顾者报告、社会功能和由盲临床医生评定的临界症状。在基线、10、20 和 30 周后以及治疗结束 (EOT) 时进行结果评估。ClinicalTrials.gov 标识符是 NCT02068326。结果 在 EOT 时,MBT-G 组的主要结果为 71.3 (SD = 15.0),TAU 组为 71.3 (SD = 15.2)(调整后平均差 0.4 BPFS-C 单位支持 MBT-G,95% 置信度间隔 -6.3 到 7.1,p = .91)。在次要结果中没有发现显着的组间差异。两组中都有 29% 的人汇款。29% 的 MBT 组完成了不到一半的课程,而对照组的这一比例为 7%。结论 没有迹象表明这两种治疗方法的优越性。低缓解率表明继续研究早期干预的重要性。具体来说,需要解决保留问题。
更新日期:2019-11-08
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