[Dialectical Behaviour Therapy for adolescents (DBT-A)--a pilot study on the therapy of suicidal, parasuicidal, and self-injurious behaviour in female patients with a borderline disorder].

OBJECTIVES In Germany suicide ranks as the second leading cause of death in adolescents. Risk factors for suicide are impulsive and self-injurious behaviour, depression, and conduct disorder. The main hypothesis of our study is that Dialectical Behavior Therapy (DBT) for adolescents is an effective method of treatment for these patients. METHODS DBT was developed by Marsha Linehan specifically for the outpatient treatment of chronically parasuicidal female patients with a diagnosis of borderline personality disorder. Miller & Rathus modified DBT for use with adolescents (DBT-A). and our group adapted the DBT-A for use in an outpatient treatment setting in Germany. In a pre-post comparison, the efficacy of treatment was measured using standardized instruments (SCL-90-R, CBCL, YSR, ILK, CGI, etc.). RESULTS In a pilot study of 12 adolescents, we found effect sizes between 1.1 and 2.9. During treatment, self-injurious behaviour declined significantly. Prior to entering therapy, 8 of the 12 patients had attempted suicide at least once. During treatment according to DBT-A there were no suicide attempts. CONCLUSIONS These results are so promising that we are now planning a randomized, multi-centre study.