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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Specialized psychotherapies for adults with borderline personality disorder: A systematic review and meta-analysis
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Specialized psychotherapies for adults with borderline personality disorder: A systematic review and meta-analysis

机译：具有边缘人格障碍的成人专门的心理治疗：系统审查和荟萃分析

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Objective: Borderline personality disorder affects up to 2% of the population and is associated with poor functioning, low quality of life and increased mortality. Psychotherapy is the treatment of choice, but it is unclear whether specialized psychotherapies (dialectical behavior therapy, mentalization-based treatment, transference-focused therapy and schema therapy) are more effective than non-specialized approaches (e.g. protocolized psychological treatment, general psychiatric management). The aim of this systematic review is to investigate the effectiveness of these psychotherapies. Methods: PubMed, PsycINFO, CINAHL, EMBASE and CENTRAL were searched from inception to November 2017. Included randomized controlled trials were assessed on risk of bias and outcomes were meta-analyzed. Confidence in the results was assessed using the Grading of Recommendations Assessment, Development and Evaluation method. The review has been reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 20 studies with 1375 participants were included. Specialized psychotherapies, when compared to treatment as usual or community treatment by experts, were associated with a medium effect based on moderate quality evidence on overall borderline personality disorder severity (standardized mean difference?=?–0.59 [95% confidence interval: –0.90, –0.28]), and dialectical behavior therapy, when compared to treatment as usual, with a small to medium effect on self-injury (standardized mean difference?=?–0.40 [95% confidence interval: –0.66, –0.13]). Other effect estimates were often inconclusive, mostly due to imprecision. Conclusion: There is moderate quality evidence that specialized psychotherapies are effective in reducing overall borderline personality disorder severity. However, further research should identify which patient groups profit most of the specialized therapies.
机译：目的：边缘人格障碍影响最多2％的人口，与功能不佳，生活质量低，增加的死亡率有关。心理疗法是选择的选择，但目前尚不清楚专业心理治疗（辩证行为治疗，基于致辩证治疗，转移的疗法治疗和模式治疗）比非专业化方法更有效（例如协议心理治疗，一般精神管理） 。这种系统审查的目的是调查这些心理治疗的有效性。方法：从成立到2017年11月，搜查了PubMed，Psycinfo，Cinahl，Embase和Central.包括随机对照试验，评估了偏见的风险，结果是荟萃分析。使用建议评估，开发和评估方法的评分评估了对结果的信心。审查已在系统评价和Meta-Analyzes指南下遵循首选报告项目。结果：共有20项研究，其中包括1375名参与者。与常规或专家的社区治疗相比，与常规或社区治疗相比，基于适度的临界人格障碍严重程度的中等效果（标准化平均差异？=？ - 0.59 [95％置信区间：-0.90， -0.28]）和辩证行为治疗，与往常一样与治疗相比，较小至中等对自损伤（标准化平均差异？=Δ - 0.40 [95％置信区间：-0.66，-0.13]）。其他效应估计通常是不确定的，主要是由于不精确。结论：有中等的质量证据表明，专门的心理治疗有效减少整体边界人格障碍严重程度。但是，进一步的研究应确定哪些患者群体利润大部分专业疗法。

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