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'Skills for pills': The dialectical-behavioural therapy skills training reduces polypharmacy in borderline personality disorder

Authors :
Soler, Joaquim
Casellas-Pujol, Elisabet
Fernández-Felipe, Isabel
Martin Blanco, Ana
Almenta, David
Pascual Mateos, Juan Carlos
Universitat Autònoma de Barcelona
Source :
ACTA PSYCHIATRICA SCANDINAVICA, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname, Repositori Universitat Jaume I, Universitat Jaume I, Dipòsit Digital de Documents de la UAB, Universitat Autònoma de Barcelona
Publication Year :
2022
Publisher :
WILEY, 2022.

Abstract

Objective: Polypharmacy and overprescription of off-label medications are common in patients with borderline personality disorder (BPD). The aim of the present naturalistic study was to explore whether the skills training module of dialectical-behavioural therapy (DBT) can reduce polypharmacy in these patients in routine clinical practice. Methods: Retrospective, observational study of 377 patients with a primary diagnosis of BPD consecutively admitted to the BPD outpatient unit from 2010 through 2020. All patients were invited to participate in the DBT skills training module (DBT-ST). DBT-ST participants (n = 182) were compared with a control group who did not participate in DBT-ST (n = 195). Pre-post intervention changes in medication load and use of antidepressants, benzodiazepines, mood stabilizers, and antipsychotics were evaluated. Results: At baseline, most patients (84.4%) were taking at least one medication and 46.9% were on polypharmacy. Compared to controls, patients in the DBT-ST group presented a significant reduction in the number of medications (2.67–1.95 vs. 2.16–2.19; p < 0.001), medication load (4.25–3.05 vs. 3.45–3.48; p < 0.001), use of benzodiazepines (54.4%–27.5% vs. 40%–40.5%; p < 0.001), mood stabilizers (43.4%–33% vs. 36.4%–39.5%; p < 0.001), and antipsychotics (36.3%–29.1% vs. 34.4%–36.9%; p < 0.001). Conclusions: These findings suggest that patients with BPD can benefit from the DBT-ST module, which may reduce the medication load, particularly of sedatives. The results suggest that DBT-ST may be useful to treat overmedication in patients with BPD and could help to promote “deprescription” in clinical practice. This study was supported by Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM). The authors would like to thank Bradley Londres for professional English language editing.

Details

ISSN :
0001690X
Database :
OpenAIRE
Journal :
ACTA PSYCHIATRICA SCANDINAVICA, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname, Repositori Universitat Jaume I, Universitat Jaume I, Dipòsit Digital de Documents de la UAB, Universitat Autònoma de Barcelona
Accession number :
edsair.doi.dedup.....7f78867ea08a64124390087a7465080b