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A systematic review of interventions for co-occurring substance use and borderline personality disorders

机译：对同时发生的物质使用和边缘性人格障碍的干预措施的系统评价

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Issues. The aim of this study was to undertake a systematic review on effective treatment options for co-occurring substance use and borderline personality disorders to examine effective treatments for this group. Approach. A systematic review using a narrative analysis approach was undertaken as there were too few studies within each intervention type to undertake a meta-analysis. The inclusion criteria comprised of English language studies (between 1999 and 2014) and a sample of >70% borderline personality disorder, with measurable outcomes for substance use and borderline personality disorder. All abstracts were screened (n = 376) resulting in 49 studies assessed for eligibility, with 10 studies, examining three different treatment types, included in the final review. Key Findings. There were four studies that examined dialectical behaviour therapy (DBT), three studies that examined dynamic deconstructive psychotherapy (DDP) and three studies that examined dual-focused schema therapy (DFST). Both DBT and DDP demonstrated reductions in substance use, suicidal/self-harm behaviours and improved treatment retention. DBT also improved global and social functioning. DFST reduced substance use and both DFST and DPP improved treatment utilisation, but no other significant positive changes were noted. Implications. Overall, there were a small number of studies with small sample sizes, so further research is required. However, in the absence of a strong evidence base, there is a critical need to respond to this group with co-occurring borderline personality disorder and substance use. Conclusion. Both DBT and DPP showed some benefit in reducing symptoms, with DBT the preferred option given its superior evidence base with women in particular.
机译：问题。这项研究的目的是对同时发生的物质使用和边缘性人格障碍的有效治疗方案进行系统的审查，以检查该组的有效治疗方法。方法。由于每种干预类型内的研究太少，无法进行荟萃分析，因此采用叙述性分析方法进行了系统评价。纳入标准包括英语研究（1999年至2014年）和样本> 70％的边缘性人格障碍，对于药物使用和边缘性人格障碍具有可衡量的结果。筛选了所有摘要（n = 376），结果评估了49项研究的合格性，其中10项研究检查了三种不同的治疗类型，包括在最终评价中。重要发现。有四项研究检查了辩证行为疗法（DBT），三项研究检查了动态破坏性心理疗法（DDP），三项研究检查了双焦点模式疗法（DFST）。 DBT和DDP均表明减少了药物使用，自杀/自残行为并改善了治疗保留率。 DBT还改善了全球和社会功能。 DFST减少了物质使用，DFST和DPP均提高了治疗利用率，但未发现其他明显的积极变化。含义。总体而言，有少量样本量较小的研究，因此需要进一步研究。然而，在缺乏强有力的证据基础的情况下，迫切需要以共同发生的边缘性人格障碍和物质使用来应对这一群体。结论。 DBT和DPP都显示出在减轻症状方面的一些益处，DBT是首选的选择，因为它尤其在女性中拥有优越的证据基础。

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