Addition of methylphenidate to intensive dialectical behaviour therapy for patients suffering from comorbid borderline personality disorder and ADHD: a naturalistic study
| Autor: | Nader Perroud, Jean-Michel Aubry, Paco Boris Prada, Julien Zimmermann, Rosetta Nicastro, Roland Hasler |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Patient Dropouts media_common.quotation_subject Comorbidity Anger behavioral disciplines and activities ddc:616.89 Barratt Impulsiveness Scale Behavior Therapy Borderline Personality Disorder mental disorders medicine Humans Attention deficit hyperactivity disorder Psychiatry Borderline personality disorder Depression (differential diagnoses) media_common Methylphenidate General Medicine medicine.disease Combined Modality Therapy Psychiatry and Mental health Clinical Psychology Attention Deficit Disorder with Hyperactivity Beck Hopelessness Scale Central Nervous System Stimulants Female Psychology medicine.drug |
| Zdroj: | Attention Deficit and Hyperactivity Disorders, Vol. 7, No 3 (2015) pp. 199-209 |
| ISSN: | 1866-6116 |
| Popis: | Attention deficit hyperactivity disorder (ADHD) is frequently comorbid with borderline personal- ity disorder (BPD). However, few studies have examined how comorbid BPD-ADHD patients, treated or not with methylphenidate (MPH), respond to psychotherapy com- pared to non-comorbid BPD patients. In this perspective, we used a naturalistic study to compare, during a month- long intensive dialectical behaviour therapy (DBT), the clinical course of BPD patients and comorbid BPD-ADHD patients who were treated or untreated with MPH. Out of the 158 BPD patients recruited, 59 had adult ADHD as a comorbidity; among these, 29 underwent a treatment with MPH or des-methylphenidate, while the 30 others did not. MPH treatment was given non-randomly and only when ADHD was considered to be hampering the capacity of the subjects to follow the therapy. Patients completed the fol- lowing forms upon admission and after 1 month of treat- ment: the adult ADHD Self-Report Scale (ASRS v.1.1), the Barratt Impulsiveness Scale (BIS-10), the State-Trait Anger Expression (STAXI), the Beck Depression Inven- tory II (BDI-II), and the Beck Hopelessness Scale. At baseline, comorbid BPD-ADHD patients showed signifi- cantly higher impulsiveness than BPD patients. In the entire sample, there was a significant decrease in all dimensions ranging from small to large effect sizes during the 4-week intensive DBT. BPD-ADHD patients who were undergoing MPH treatment showed a significantly improved response to DBT treatment for Trait-State Anger scores, motor impulsiveness, depression severity, and ADHD severity, when compared to those without stimulant medication. This study outlines the importance of sys- tematically screening BPD patients for ADHD, since a MPH-based treatment will improve the symptoms of patients who are comorbid for BPD and ADHD. Due to the non-random allocation of subjects, more severely affected patients were more readily placed on MPH; this suggests that the more severe the ADHD symptoms, the greater the chance for the patient of being treated. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|