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Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting

BACKGROUND: Emotional dysregulation in psychiatric disorders contributes to morbidity, mortality and healthcare costs. Dialectical behaviour therapy (DBT) is effective in addressing this, but is complex and costly to implement. Recent literature indicates that DBT can be modified for use in resource...

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Autores principales: Steyn, Petrus J., Koen, Liezl, Jarvis, Lucy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832019/
https://www.ncbi.nlm.nih.gov/pubmed/35169509
http://dx.doi.org/10.4102/sajpsychiatry.v28i0.1701
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author Steyn, Petrus J.
Koen, Liezl
Jarvis, Lucy
author_facet Steyn, Petrus J.
Koen, Liezl
Jarvis, Lucy
author_sort Steyn, Petrus J.
collection PubMed
description BACKGROUND: Emotional dysregulation in psychiatric disorders contributes to morbidity, mortality and healthcare costs. Dialectical behaviour therapy (DBT) is effective in addressing this, but is complex and costly to implement. Recent literature indicates that DBT can be modified for use in resource-limited settings, but little is known about its implementation in African settings. AIM: To describe the demographic and clinical characteristics of participants in a modified DBT-ST (skills training) programme at a South African psychiatric hospital. SETTING: The study was conducted at Stikland Hospital, a public psychiatric hospital in the Western Cape province, South Africa. METHODS: A retrospective, cross-sectional chart review of patients included in a modified inpatient DBT-ST programme between 30 June 2014 and 30 June 2019 was conducted. Descriptive analyses were performed on the data both as a complete set and after division into several subgroups. RESULTS: We included 349 records. Two-thirds of the patients completed the programme. Major depressive disorder, borderline personality disorder and substance use disorder were the most prevalent diagnoses. Most patients had psychiatric comorbidities. A total of 90.61% (n = 309) of the patients were exposed to at least one traumatic event and three-quarters (n = 261) had attempted suicide at least once before. CONCLUSIONS: The demographics of our sample did not differ markedly from the international literature. Rather, what stood out was that modified DBT-ST could be a choice in resource-limited settings for a diagnostically heterogeneous group that displayed significant clinical complexity and high levels of emotional dysregulation. Our findings might suggest that the intervention was well tolerated and possibly most appropriately delivered at the first admission, although further research is required.
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spelling pubmed-88320192022-02-14 Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting Steyn, Petrus J. Koen, Liezl Jarvis, Lucy S Afr J Psychiatr Original Research BACKGROUND: Emotional dysregulation in psychiatric disorders contributes to morbidity, mortality and healthcare costs. Dialectical behaviour therapy (DBT) is effective in addressing this, but is complex and costly to implement. Recent literature indicates that DBT can be modified for use in resource-limited settings, but little is known about its implementation in African settings. AIM: To describe the demographic and clinical characteristics of participants in a modified DBT-ST (skills training) programme at a South African psychiatric hospital. SETTING: The study was conducted at Stikland Hospital, a public psychiatric hospital in the Western Cape province, South Africa. METHODS: A retrospective, cross-sectional chart review of patients included in a modified inpatient DBT-ST programme between 30 June 2014 and 30 June 2019 was conducted. Descriptive analyses were performed on the data both as a complete set and after division into several subgroups. RESULTS: We included 349 records. Two-thirds of the patients completed the programme. Major depressive disorder, borderline personality disorder and substance use disorder were the most prevalent diagnoses. Most patients had psychiatric comorbidities. A total of 90.61% (n = 309) of the patients were exposed to at least one traumatic event and three-quarters (n = 261) had attempted suicide at least once before. CONCLUSIONS: The demographics of our sample did not differ markedly from the international literature. Rather, what stood out was that modified DBT-ST could be a choice in resource-limited settings for a diagnostically heterogeneous group that displayed significant clinical complexity and high levels of emotional dysregulation. Our findings might suggest that the intervention was well tolerated and possibly most appropriately delivered at the first admission, although further research is required. AOSIS 2022-01-28 /pmc/articles/PMC8832019/ /pubmed/35169509 http://dx.doi.org/10.4102/sajpsychiatry.v28i0.1701 Text en © 2022. The Authors https://creativecommons.org/licenses/by/4.0/Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Original Research
Steyn, Petrus J.
Koen, Liezl
Jarvis, Lucy
Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting
title Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting
title_full Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting
title_fullStr Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting
title_full_unstemmed Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting
title_short Characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting
title_sort characteristics of inpatients in dialectical behaviour therapy modified for a resource-limited setting
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832019/
https://www.ncbi.nlm.nih.gov/pubmed/35169509
http://dx.doi.org/10.4102/sajpsychiatry.v28i0.1701
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