Beth S. Brodsky, Ph.D. beth.brodsky@nyspi.columbia.edu, Hanga Galfalvy, Ph.D., J. John Mann, M.D., Michael F. Grunebaum, M.D., and Barbara Stanley, Ph.D.
https://doi.org/10.1176/appi.ajp.20240298
Abstract
Objective:
The authors compared the efficacy of 6 months of dialectical behavior therapy (DBT) to 6 months of selective serotonin reuptake inhibitors with clinical management (SSRI/M) in reducing suicide-related events (SREs), suicide attempts, nonsuicidal self-injury (NSSI), and related clinical outcomes in individuals diagnosed with borderline personality disorder.
Methods:
The study sample comprised 84 individuals with borderline personality disorder; more than one suicide attempt, SRE, or NSSI episode in the past 6 months; and another of these behaviors in the past year. Two-thirds had comorbid major depressive disorder. Participants were randomly assigned to receive DBT or SSRI/M. Poisson models were used to analyze numbers of suicide attempts and SREs, and a zero-inflated Poisson model was used for NSSI behaviors. Survival analysis was performed with the log-rank test for time to first suicide attempt or SRE. Follow-up assessments at 12 months were analyzed in a separate model. Mixed-effects regression was used to compare quantitative outcomes.
Results:
Significantly fewer SREs occurred in the DBT arm compared with the SSRI/M arm during the 6-month treatment phase. Significantly fewer suicide attempts occurred in the DBT arm compared with the SSRI/M arm. Survival analysis indicated significantly lower risk for having any SRE in the DBT arm compared with the SSRI/M arm, but no difference in risk of suicide attempt. DBT participants had significantly lower NSSI counts than SSRI/M participants. Severity of depression and suicidal ideation decreased comparably in both treatment groups. After 6 months of treatment, the rate of major depressive disorder was significantly lower in the SSRI/M arm compared with the DBT arm. At 12-month follow-up (6 months after completion of the treatment phase), outcomes were comparable between the two groups.
Conclusions:
Six months of DBT showed greater efficacy than 6 months of SSRI/M in reducing SRE and NSSI behaviors in patients with borderline personality disorder.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.