Dialektisk atferdsterapi – en relevant behandling for pasienter med rusmisbruk og emosjonelt ustabil personlighetsforstyrrelse?
DOI:
https://doi.org/10.5617/suicidologi.2244Abstract
Emosjonelt ustabil personlighetsforstyrrelse og ruslidelser er vanlig i kliniske populasjoner og diagnostisk komorbiditet mellom disse lidelsene forekommer ofte. En slik komorbiditet gir ofte en negativ additiv effekt, for debut av lidelsen, forløp, prognose og behandling. Det er holdepunkter for å hevde at de deler en felles etiologi i form av emosjonell dysregulering og impulskontrollsvikt. Dialektisk adferdsterapi (DBT) kombinerer en kognitiv atferdsterapeutisk tilnærming med akseptorienterte strategier og en dialektisk filosofisk holdning. DBT er empirisk validert som effektiv behandling for personer med ustabil personlighetsforstyrrelse. I denne artikkelen undersøkte vi om litteraturen tilsier at DBT også er et hensiktsmessig behandlingstilbud til pasienter med både ustabil personlighetsforstyrrelse og ruslidelse. Et litteratursøk identifiserte tre studier som undersøker dette. Resultatene er ikke entydige, men samlet sett gir de et optimistisk grunnlag til støtte for at DBT kan være et hensiktsmessig tilbud også for ruspasienter, både knyttet til reduksjon av rusmiddelmisbruk, lavere drop-out rate fra behandling og at behandlingseffekten kan vare over tid. Borderline personality disorder and substance use disorders are prevalent in clinical samples, and they often co-occur. The co-occurrence of these disorders often increases the risk for problems, and has negative impact on the trajectory, prognosis and treatment. The assumption that both disorders share the same underlying problems of emotional dysregulation is supported by a large body of evidence. Dialectical behaviour therapy, a treatment developed for patients with borderline personality disorder addresses directly the core problems of regulating emotions. The aim of this literature review was to examine whether this specific treatment had evidence regarding effectiveness also for patients with co-morbid borderline personality disorder and substance use disorder. The article is based on non-systematic literature review, and found three studies who directly examined the effect of dialectical behaviour therapy for this group. The results from these studies are promising, indicating less use of substances, lower dropout rate, and the observed effect lasts over time.References
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