Dialektisk atferdsterapi for ungdommer med gjentatt suicidal og selvskadende adferd – en randomisert kontrollert undersøkelse


  • Lars Mehlum
  • Anita Johanna Tørmoen
  • Maria Ramberg
  • Egil Haga
  • Lien My Diep
  • Anne Mari Sund
  • Berit Grøholt




Vi undersøkte hvorvidt en forkortet versjon av dialektisk atferdsterapi tilpasset for tenåringer (DBT-A) er mer effektiv enn vanlig behandling (VB) i å redusere villet egenskade. I undersøkelsen deltok 77 ungdommer med nylig og repetert villet egenskade, tilfeldig fordelt til å motta enten DBT-A eller VB i 19 uker. Vi målte antall episoder med villet egenskade, nivå av selvmordstanker, depresjon, håpløshet og symptomer på ustabil personlighetsforstyrrelse ved behandlingsstart og etter 9, 15 og 19 uker. Vi fant at de fleste ungdommene i begge grupper fullførte behandlingen og at bruken av krisetjenester var beskjeden. De ungdommene som fikk DBT-A, rapporterte imidlertid signifikant færre episoder med villet egenskade og lavere nivå av selvmordstanker og depresjonsymptomer enn ungdommene som fikk VB. Vår konklusjon er at DBT-A er mer effektivt i å behandle ungdommer med villet egenskade enn vanlig behandling. We examined whether a shortened form of dialectical behavior therapy (DBT-A) is more effective than enhanced usual care (EUC) to reduce self-harm in adolescents. This was a randomized study of 77 adolescents with recent and repetitive self-harm treated at community child and adolescent psychiatric outpatient clinics randomly allocated to either DBT-A or EUC. Assessments of self-harm, suicidal ideation, depression, hopelessness and symptoms of borderline personality disorder were made at baseline and after 9, 15 and 19 weeks (end of trial period) and frequency of hospitalizations and emergencydepartment visits over the trial period were recorded. Treatment retention was generally good in both treatment conditions and the use of emergency services was low. DBT-A was superior to EUC in reducing self-harm, suicidal ideation and depressive symptoms. Effect sizes were large for treatment outcomes in patients who received DBT-A, whereas effect sizes were small for outcomes in patients receiving EUC. We conclude that DBT-A may be an effective intervention to reduce self-harm, suicidal ideation and depression and adolescents with repetitive self-harming behavior.


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