Cognitive therapy v. usual treatment for borderline personality disorder: prospective 6-year follow-up
Cognitive therapy v. usual treatment for borderline personality disorder: prospective 6-year follow-up
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DOI：
10.1192/bjp.bp.109.074286
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发表时间：
2010-12-01
影响因子：
10.5
通讯作者：
Tyrer, Helen
中科院分区：
文献类型：
--
作者：
Davidson, Kate M.;Tyrer, Peter;Tyrer, Helen
背景边缘型人格障碍患者的长期随访发现了良好的临床结果，症状和诊断的长期减少。在BOSCOT试验中，我们检查了边缘型人格障碍患者的6年结果，这些患者随机接受1年的认知行为治疗人格障碍（CBT-PD）或常规治疗（TAU）。在三个中心在英国（试验注册：ISRCTN 86177428）MethodIn总数，106名参与者符合标准的边缘型人格障碍在原来的试验。在随访时，研究助理对患者的原始治疗组、CBT-PD或TAU设盲，使用与原始随机试验相同的措施对患者进行访谈。作为一个整体的组的数据的统计分析是基于广义线性模型与重复测量方差分析类型的models，以检查组differences.ResultsFollow-up的数据，获得了82%的患者在6年。超过一半的患者在进入研究时符合边缘型人格障碍的标准，6年后不再符合。1年随访后，CBT-PD在减少自杀行为方面优于TAU。住院时间和服务成本较低的CBT-PD组相比，TAU group.ConclusionsAlthough使用CBT-PD没有表现出统计学上显着的成本效益优势，研究结果表明，潜在的持续长期的成本抵消，累计后最初提供1年的CBT-PD。但生活质量和情感障碍仍较差。
BackgroundLonger-term follow-up of patients with borderline personality disorder have found favourable clinical outcomes, with long-term reduction in symptoms and diagnosis.AimsWe examined the 6-year outcome of patients with borderline personality disorder who were randomised to 1 year of cognitive-behavioural therapy for personality disorders (CBT-PD) or treatment as usual (TAU) in the BOSCOT trial, in three centres across the UK (trial registration: ISRCTN86177428).MethodIn total, 106 participants met criteria for borderline personality disorder in the original trial. Patients were interviewed at follow-up by research assistants masked to the patient's original treatment group, CBT-PD or TAU, using the same measures as in the original randomised trial. Statistical analyses of data for the group as a whole are based on generalised linear models with repeated measures analysis of variance type models to examine group differences.ResultsFollow-up data were obtained for 82% of patients at 6 years. Over half the patients meeting criteria for borderline personality disorder at entry into the study no longer did so 6 years later. The gains of CBT-PD over TAU in reduction of suicidal behaviour seen after 1-year follow-up were maintained. Length of hospitalisation and cost of services were lower in the CBT-PD group compared with the TAU group.ConclusionsAlthough the use of CBT-PD did not demonstrate a statistically significant cost-effective advantage, the findings indicate the potential for continued long-term cost-offsets that accrue following the initial provision of 1 year of CBT-PD. However, the quality of life and affective disturbance remained poor.