Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder a two-year follow-up preliminary randomized study 英文参考文献.docVIP

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Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder a two-year follow-up preliminary randomized study 英文参考文献.doc

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Supervised team management, with or without structured psychotherapy, in heavy users of a mental health service with borderline personality disorder a two-year follow-up preliminary randomized study 英文参考文献

Amiantoetal.BMCPsychiatry2011,11:181 /1471-244X/11/181 RESEARCH ARTICLE OpenAccess Supervisedteammanagement,withorwithout structuredpsychotherapy,inheavyusersofa mentalhealthservicewithborderlinepersonality disorder:atwo-yearfollow-uppreliminary randomizedstudy FedericoAmianto1?,AndreaFerrero2,3?,AndreaPierò4,ElisabettaCairo2,3,GiuseppeRocca1,BarbaraSimonelli2,3, SimonaFassina2,3,GiovanniAbbate-Daga1andSecondoFassino1* Abstract Background:IndividualsaffectedbysevereBorderlinePersonalityDisorder(BPD)areoftenheavyusersofMental HealthServices(MHS).Short-termtreatmentscurrentlyusedinBPDtherapyareusefultotargetdisruptive behaviorsbuttheyarelesseffectiveinreducingheavyMHSuse.Therefore,alternativeshort-termtreatments,less complexthanlong-termpsychodynamicpsychotherapiesbutspecificallyorientedtoBPDcoreproblems,needto bedevelopedtoreduceMHSoveruse.ThisstudyaimedtoevaluatetheefficacyofaddingSequentialBriefAdlerian PsychodynamicPsychotherapy(SB-APP)toSupervisedTeamManagement(STM)inBPDtreatmentcomparedto STMaloneinanaturalisticgroupofheavyMHSuserswithBPD.Effectivenesswasevaluated6timesalongatwo- yearfollow-up. Methods:Thirty-fiveoutpatientswhometinclusioncriteriawererandomlyassignedtotwotreatmentgroups(STM =17;SB-APP=18)andthencompared.ClinicalGlobalImpression(CGI)andCGI-modified(CGI-M)forBPD,Global AssessmentofFunctioning(GAF),State-TraitAngerExpressionInventory(STAXI),andSymptomChecklist-90Revised (SCL-90-R)wereadministeredatT1,T3,T6,T12,T18andT24.AtT12theWorkingAllianceInventory-ShortForm (WAI-S)wasalsocompleted.Attheone-yearfollow-up,SB-APPgroupdidnotreceiveanyadditionalindividual psychologicalsupport.MHSteamwasspecificallytrainedinBPDtreatmentandhadregularsupervisions. Results:AllpatientsimprovedonCGI,GAF,andSTAXIscoresafter6and12months,independentlyoftreatment received.SB-APPgroupshowedbetteroutcomeonimpulsivity,suicideattempts,chronicfeelingsofemptiness, anddisturbedrelationships.Wefoundagoodstabilizationattheoneyearfollow-up,evenaftertheinterruptionof briefpsychother