The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial.
The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial.
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DOI：
10.1521/pedi.2006.20.5.450
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发表时间：
2006-10
影响因子：
2.3
通讯作者：
Palmer S
中科院分区：
文献类型：
--
作者：
Davidson K;Norrie J;Tyrer P;Gumley A;Tata P;Murray H;Palmer S
描述了一项在常规治疗的基础上加认知行为疗法(CBT+TAU)和单独TAU(TAU)的随机对照试验的结果，该试验在106名符合临界性人格障碍诊断标准的参与者中进行了比较。我们预计，与TAU相比，CBT加TAU在12个月的治疗和12个月的随访中，将减少住院精神病住院、急诊室接触或自杀行为的参与者的数量。我们还预计，与TAU相比，CBT加TAU将导致心理健康和社会功能的一系列次要结果的改善。在随机抽取的106名参与者中，有102人(96%)在两年内获得了随访数据。那些被随机分配到CBT的患者在12个月内平均接受27次治疗，平均参加16次(范围从0到35)。我们发现，在随机化后的24个月内，CBT加TAU组的参与者与单独的TAU组相比，有任何自杀行为、住院或意外和紧急接触的结果的全球优势比为0.86(95%可信区间[CI]0.45至1.66，p=0.66)。相应的全球优势比(不包括急诊室接触)为0.75(95%可信区间为0.37比1.54，p=0.44)。就自杀行为的数量而言，在过去两年中，支持CBT加TAU的患者明显少于TAU，平均差异−为0.91%(95%CI−1.67至−0.15，p=0.020)。在两个治疗组中，初次和次要结果都有逐渐和持续的改善，有证据表明，CBT在一年时增加了阳性症状痛苦指数，在两年的随访中增加了状态焦虑、功能障碍信念和自杀行为的数量。在真实的临床环境中，CBT可以在相对较少的临床会议中提供临床上重要的变化。
The outcome of a randomized controlled trial of cognitive behavior therapy in addition to treatment as usual (CBT plus TAU) compared with TAU alone (TAU) in one hundred and six participants meeting diagnostic criteria for borderline personality disorder is described. We anticipated that CBT plus TAU would decrease the number of participants with in-patient psychiatric hospitalizations or accident and emergency room contact or suicidal acts over twelve months treatment and twelve months follow-up, compared with TAU. We also anticipated that CBT plus TAU would lead to improvement in a range of secondary outcomes of mental health and social functioning compared to TAU. Of the 106 participants randomized, follow-up data on 102 (96%) was obtained at two years. Those randomized to CBT were offered an average of 27 sessions over 12 months and attended on average 16 (range 0 to 35). We found that the global odds ratio of a participant in the CBT plus TAU group compared with the TAU alone group having any of the outcomes of a suicidal act, in-patient hospitalization, or accident and emergency contact in the 24 months following randomization was 0.86 (95% confidence interval [CI] 0.45 to 1.66, p = 0.66). The corresponding global odds ratio, excluding accident and emergency room contact, was 0.75 (95% CI 0.37 to 1.54, p = 0.44). In terms of the number of suicidal acts, there was a significant reduction over the two years in favor of CBT plus TAU over TAU, with a mean difference of −0.91 (95% CI −1.67 to −0.15, p = 0.020). Across both treatment arms there was gradual and sustained improvement in both primary and secondary outcomes, with evidence of benefit for the addition of CBT on the positive symptom distress index at one year, and on state anxiety, dysfunctional beliefs and the quantity of suicidal acts at two year follow-up. CBT can deliver clinically important changes in relatively few clinical sessions in real clinical settings.
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影响因子：
2.3
作者：
Davidson K;Tyrer P;Gumley A;Tata P;Norrie J;Palmer S;Millar H;Drummond L;Seivewright H;Murray H;Macaulay F
通讯作者：
Macaulay F
影响因子：
7.5
作者：
Tyrer, P;Nur, U;Johnson, T
通讯作者：
Johnson, T
影响因子：
2.3
作者：
Zanarini, MC;Frankenburg, FR;Silk, KR
通讯作者：
Silk, KR
影响因子：
2.9
作者：
Turner, RM
通讯作者：
Turner, RM
影响因子：
17.7
作者：
Bateman, A;Fonagy, P
通讯作者：
Fonagy, P