Estudio comparativo de psicoterapia de grupo para el tratamiento de pacientes con trastorno límite de la personalidad / Comparative study of group psychotherapy for the treatment of patients with borderline personality disorder
Salud ment
;
32(3): 241-249, may.-jun. 2009. tab
Article
in Spanish
|
LILACS-Express
| LILACS
| ID: lil-632648
ABSTRACT
Nowadays, psychotherapy is regarded as the treatment of choice for patients with Borderline Personality Disorder(BPD). A consensus has yet to be reached, however, despite various controlled studies undertaken to determine the most suitable form of treatment. At both public and private mental health institutions, there is a growing number of BPD patients seeking treatment. These patients pose a challenge for institutional programs because their demands usually exceed the <<therapeutic capacity>> of conventional forms of psychiatric treatment. Due to this heavy demand, various strategies have been examined in order to treat this type of patients properly. These include short group therapy. This article presents the results of a controlled clinical study comparing the effectiveness of treatment according to the composition of the groups a homogeneous group, consisting solely of borderline patients and another in which only half had been diagnosed with BPD while the others only had Axis 1 disorders, with no serious personality pathology. The study considered the variables of psychiatric symptomatology, quality of life, self-esteem, <<ego strength>>, perceived social support, social adjustment and inter-personal problems. Both groups contained female subjects only. The quantitative results of the mixed group show significant changes in the psychiatric symptoms as well as the evolution of interpersonal problems and current quality of life. At the same time, the homogeneous group showed changes in the ideal quality of life and the self-esteem scale. A comparison of the base and final scores showed that the BPD group showed no reduction in psychiatric symptomatology, nor was there a positive evolution in inter-personal relations. At the same time, when other groups were compared, it was obvious that patients in the mixed group showed greater changes in interpersonal problems and depression, anxiety, paranoid and hostility symptoms. As for qualitative results, the BPD group constituted a failed experience from the psychotherapeutic point of view. An analysis of the development of the process in the BPD group reveals three different stages. The first was characterized by the early emergence of numerous transfers based on the idealization/devaluation of colleagues and therapists. The splitting mechanism was clearly observed. This stage saw the emergence of high expectations of a <RESUMEN
En la actualidad se acepta que el tratamiento de elección para los pacientes con Trastorno Límite de la Personalidad (TLP) es la psicoterapia. Sin embargo, a pesar de los diversos estudios controlados que se han realizado con el propósito de determinar cuál es la modalidad de tratamiento más adecuada, no se ha logrado alcanzar consenso. En las instituciones de atención a la salud mental, tanto públicas como privadas, es creciente el volumen de pacientes con TLP que buscan tratamiento. Debido a estas fuertes demandas que operan sobre las instituciones, se han buscado diferentes estrategias para tratar adecuadamente a este tipo de pacientes. Entre ellas se destaca la terapia de grupo breve. La mayoría de los estudios que han respaldado los tratamientos psicoterapéuticos para el TLP derivan de observaciones provenientes de ensayos clínicos individuales. Sin embargo, también existen trabajos entre los que se reseñan algunos que consideramos relevantes y que muestran los beneficios de los tratamientos grupales. En este artículo se presentan los resultados de un estudio clínico controlado comparando dos tipos de conformación de grupos terapéuticos un grupo homogéneo, constituido únicamente por pacientes limítrofes, y otro heterogéneo en el que se incluyeron además de pacientes con TLP, otros sin patología grave de la personalidad. El objetivo del estudio fue comparar la efectividad del tratamiento en función de la composición de los grupos. El tipo de estudio fue comparativo pre-test post-test. En él se consideraron las variables de sintomatología psiquiátrica, la calidad de vida, la autoestima, la <
Full text:
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Index:
LILACS (Americas)
Type of study:
Prognostic study
/
Qualitative research
Language:
Spanish
Journal:
Salud ment
Journal subject:
Psychiatry
Year:
2009
Type:
Article
Affiliation country:
Mexico
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