Acute treatment outcomes in patients with bipolar I disorder and co-morbid borderline personality disorder receiving medication and psychotherapy.
Acute treatment outcomes in patients with bipolar I disorder and co-morbid borderline personality disorder receiving medication and psychotherapy.
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接受药物和心理治疗的 I 型双相情感障碍和共病边缘性人格障碍患者的急性治疗结果。
DOI：
10.1111/j.1399-5618.2005.00179.x
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发表时间：
2005
影响因子：
5.4
通讯作者：
Scott,John
中科院分区：
文献类型：
--
作者：
Swartz,HollyA;Pilkonis,PaulA;Frank,Ellen;Proietti,JosephM;Scott,John
目的：双相I型和边缘型人格障碍（BPD）患者的治疗面临着独特的挑战。这项配对病例对照研究的目的是比较符合双相I型障碍和BPD标准化诊断标准的患者样本（n = 12）和仅符合双相I型障碍标准的患者样本（n = 58）的急性治疗结果。方法：符合急性情感发作标准的受试者接受算法驱动的药物治疗和每周心理治疗的组合治疗，直到稳定（定义为连续四周，汉密尔顿抑郁评定量表和Bech - Rafaelsen躁狂量表的17项计算平均值总计≤7）。结果：12例双相- BPD患者中只有3例（25%）达到稳定，而58例双相- BPD患者中有43例（74%）达到稳定。三名双相- BPD患者中有两名稳定了95周以上，而双相- BPD组的中位稳定时间为35周。双相- BPD组每年接受的非典型情绪稳定药物明显多于双相组（Z= 4.3, p < 0.0001）。合并症组的辍学率很高。结论：这项准实验研究表明，双相I型和BPD患者的治疗过程可能更长。一些患者通过药物治疗和心理治疗有明显改善，表明这种方法值得进一步研究。
Objective:Patients suffering from both bipolar I disorder and borderline personality disorder (BPD) pose unique treatment challenges. The purpose of this matched case–control study was to compare acute treatment outcomes of a sample of patients who met standardized diagnostic criteria for both bipolar I disorder and BPD (n = 12) to those who met criteria for bipolar I disorder only (n = 58).Method:Subjects meeting criteria for an acute affective episode were treated with a combination of algorithm‐driven pharmacotherapy and weekly psychotherapy until stabilization (defined as four consecutive weeks with a calculated average of the 17‐item version of the Hamilton Rating Scale for Depression and Bech‐Rafaelsen Mania scale totaling ≤7).Results:Only three of 12 (25%) bipolar‐BPD patients achieved stabilization, compared with 43 of 58 (74%) bipolar‐only patients. Two of the three bipolar‐BPD patients who did stabilize took over 95 weeks to do so, compared with a median time‐to‐stabilization of 35 weeks in the bipolar‐only group. The bipolar‐BPD group received significantly more atypical mood‐stabilizing medications per year than the bipolar‐only group (Z= 4.3, p < 0.0001). Dropout rates in the comorbid group were high.Conclusions:This quasi‐experimental study suggests that treatment course may be longer in patients suffering from both bipolar I disorder and BPD. Some patients improved substantially with pharmacotherapy and psychotherapy, suggesting that this approach is worthy of further investigation.