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The Effectiveness of Dialectical Behavior Therapy Compared to Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial.

التفاصيل البيبلوغرافية
العنوان: The Effectiveness of Dialectical Behavior Therapy Compared to Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial.
المؤلفون: Assmann N; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.; Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany., Schaich A; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.; Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany., Arntz A; Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands., Wagner T; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany., Herzog P; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.; Department of Psychology, Harvard University, Cambridge, Massachusetts, USA.; Department of Psychology, University of Kaiserslautern-Landau, Landau, Germany., Alvarez-Fischer D; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.; Institute of Neurogenetics, University of Lübeck, Lübeck, Germany., Sipos V; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany., Jauch-Chara K; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.; Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany., Klein JP; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany., Hüppe M; Department of Anaesthesiology, University of Lübeck, Lübeck, Germany., Schweiger U; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany., Fassbinder E; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.; Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.
المصدر: Psychotherapy and psychosomatics [Psychother Psychosom] 2024; Vol. 93 (4), pp. 249-263. Date of Electronic Publication: 2024 Jul 10.
نوع المنشور: Journal Article; Randomized Controlled Trial; Comparative Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Karger Country of Publication: Switzerland NLM ID: 0024046 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1423-0348 (Electronic) Linking ISSN: 00333190 NLM ISO Abbreviation: Psychother Psychosom Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Basel : Karger
مواضيع طبية MeSH: Borderline Personality Disorder*/therapy , Dialectical Behavior Therapy*/methods, Humans ; Female ; Adult ; Male ; Treatment Outcome ; Middle Aged ; Young Adult ; Germany ; Behavior Therapy/methods ; Adolescent
مستخلص: Introduction: In the treatment of borderline personality disorder (BPD), there is empirical support for both dialectical behavior therapy (DBT) and schema therapy (ST); these treatments have never been compared directly. This study examines whether either of them is more effective than the other in treating patients with BPD.
Methods: In this randomized, parallel-group, rater-blind clinical trial, outpatients aged between 18 and 65 years with a primary diagnosis of BPD were recruited in a tertiary outpatient treatment center (Lübeck, Germany). Participants were randomized to DBT or ST with one individual and one group session per week over 1.5 years. The primary outcome was the BPD symptom severity assessed with the mean score of the Borderline Personality Disorder Severity Index at 1-year naturalistic follow-up.
Results: Between November 26, 2014, and December 14, 2018, we enrolled 164 patients (mean age = 33.7 [SD = 10.61] years). Of these, 81 (49.4%) were treated with ST and 83 (50.6%) with DBT, overall, 130 (79.3%) were female. Intention-to-treat analysis with generalized linear mixed models did not show a significant difference at 1-year naturalistic follow-up between DBT and ST for the BPDSI total score (mean difference 3.32 [95% CI: -0.58-7.22], p = 0.094, d = -24 [-0.69; 0.20]) with lower scores for DBT. Pre-to-follow-up effect sizes were large in both groups (DBT: d = 2.45 [1.88-3.02], ST: d = 1.78 [1.26-2.29]).
Conclusion: Patients in both treatment groups showed substantial improvements indicating that even severely affected patients with BPD and various comorbid disorders can be treated successfully with DBT and ST. An additional non-inferiority trial is needed to show if both treatments are equally effective. The trial was retrospectively registered on the German Clinical Trials Register, DRKS00011534 without protocol changes.
(© 2024 The Author(s). Published by S. Karger AG, Basel.)
التعليقات: Erratum in: Psychother Psychosom. 2024 Aug 30:1. doi: 10.1159/000540975. (PMID: 39217972)
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فهرسة مساهمة: Keywords: Borderline personality disorder; Effectiveness; Psychotherapy research; Randomized clinical trials; Treatment outcome
تواريخ الأحداث: Date Created: 20240710 Date Completed: 20240818 Latest Revision: 20240905
رمز التحديث: 20240906
مُعرف محوري في PubMed: PMC11332312
DOI: 10.1159/000538404
PMID: 38986457
قاعدة البيانات: MEDLINE
الوصف
تدمد:1423-0348
DOI:10.1159/000538404