Introduction: Evidence-based psychotherapies for borderline personality disorder (BPD) are lengthy, posing a barrier to their access. Brief psychotherapy may achieve comparable outcomes to long-term psychotherapy for BPD. Evidence is needed regarding the comparative effectiveness of short- versus long-term psychotherapy for BPD.
Objective: The aim was to determine if 6 months of Dialectical Behavior Therapy (DBT) is noninferior to 12 months of DBT in terms of clinical effectiveness.
Methods: This two-arm, single-blinded, randomized controlled noninferiority trial with suicidal or self-harming patients with BPD was conducted at two sites in Canada. Participants (N = 240, M (SD)age = 28.27 (8.62), 79% females) were randomized to receive either 6 (DBT-6) or 12 months (DBT-12) of comprehensive DBT. Masked assessors obtained measures of clinical effectiveness at baseline and every 3 months, ending at month 24. DBT-6 and DBT-12 were outpatient treatments consisting of weekly individual therapy sessions, weekly DBT skills training group sessions, telephone consultation as needed, and weekly therapist consultation team meetings.
Results: The noninferiority hypothesis was supported for the primary outcome, total self-harm (6 months: margin = -1.94, Mdiff [95% CI] = 0.16 [-0.14, 0.46]; 12 months: margin = -1.47, Mdiff [95% CI] = 0.04 [-0.17, 0.23]; 24 months: margin = -1.25, Mdiff [95% CI] = 0.12 [-0.02, 0.36]). Results also supported noninferiority of DBT-6 for general psychopathology and coping skills at 24 months. Furthermore, DBT-6 participants showed more rapid reductions in BPD symptoms and general psychopathology. There were no between-group differences in dropout rates.
Conclusions: The noninferiority of a briefer yet comprehensive treatment for BPD has potential to reduce barriers to treatment access.
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http://dx.doi.org/10.1159/000525102 | DOI Listing |
J Surg Oncol
December 2024
Department of Cancer Epidemiology & Biostatistics, Regional Cancer Centre, Trivandrum, Kerala, India.
Background: Minimally invasive approaches for rectal cancer treatment are emerging as the standard of care. Robotic surgery is unfeasible across the country due to constrained resource allocation. This study aimed to assess the oncologic efficacy of laparoscopic resection for rectal cancer in a resource-limited setting.
View Article and Find Full Text PDFClin Oral Implants Res
December 2024
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Objective: To assess the clinical, radiographic and patient-reported outcome measures, and the success of screw-retained one-piece monolithic zirconia implant-supported restorations in the posterior region during a 1-year follow-up.
Methods: In a prospective case series, 50 single molar sites in the posterior region of 41 patients with a minimum age of 18 years and sufficient bone volume for placing an implant (≥ 8 mm) and space for an anatomical restoration were included. Following prosthetic-driven digital three-dimensional treatment planning, a tissue-level implant with an internal connection was inserted during a one-stage surgical procedure.
Per Med
December 2024
Department of Neurosurgery, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou, China.
Aims: Considerable inter-individual variability in the efficacy of valproic acid (VPA) has been reported, with approximately 20-45% of patients failing to achieve satisfactory seizure control after VPA monotherapy. The aim of this study was to investigate the influence of non-genetic and genetic factors on 12-month VPA-response in a cohort of 194 pediatric patients.
Materials & Methods: Trough concentrations were determined, and a panel of 48 variants located in pharmacokinetic and pharmacodynamic gene were genotyped.
Ann Chir Plast Esthet
December 2024
Service de chirurgie générale, pavillon militaire du CHU Sylvanus Olympio, Togo.
Introduction: In Africa, rare publications have focused on phyllodes tumors (PTs). The aim of our study is to describe the special feature of PTs surgery.
Patients And Method: Retrospective and descriptive study of 11 cases of PT operated from January 1, 2015 to March 31, 2023 at the medical-surgical clinic in Teaching Hospital Center of Sylvanus Olympio of Lome.
Zhonghua Wei Chang Wai Ke Za Zhi
December 2024
Department of Gastroenterology, Dongguan Children's Hospital Affiliated to Guangdong Medical University, Dongguan Eighth People's Hospital, Dongguan523000, China.
To evaluate the clinical efficacy of modified endoscopic mucosal resection (EMR) in the management of early gastrointestinal lesions. Upon endoscopic identification of the lesion, normal saline is injected into the submucosa to establish a fluid cushion, which elevates the lesion's mucosa. Methylene blue may also be applied to improve visualization of the relationship between the submucosa and muscular layer.
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