Abstract：
BACKGROUND: Schema therapy is effective for most outpatients with personality disorders (PDs). However, a subgroup does not sufficiently benefit from outpatient programmes. Despite its common clinical use, a thorough evaluation of day treatment group schema therapy (GST) is lacking.
OBJECTIVE: This study aimed to investigate the effectiveness of day treatment GST for patients with PDs.
METHODS: Negative core beliefs were the primary outcome in a multiple baseline single-case design, measured weekly before and during 30 weeks of day treatment GST. Secondary outcomes included severity of primary PD, early maladaptive schemas (EMS), schema modes and general psychopathology measured before and after day treatment GST. Intervention effects were evaluated through visual inspection and randomization test analysis, with a reliable change index calculated for the secondary outcome measures.
RESULTS: A total of 79% of treatment completers showed a significant positive effect of day treatment GST with large effect sizes (Cohen\'s d: 0.96-10.04). Secondary outcomes supported these findings: 56% had a significant decrease in the severity of primary PD and 53% in general psychopathology. In addition, 63% of EMS and 72% of schema modes (87.5% for functional schema modes) showed significant positive reliable changes.
CONCLUSIONS: This is the first empirical study that demonstrated the effectiveness of day treatment GST in patients with severe PDs. Day treatment GST can serve as a stepped care treatment option for nonresponsive patients in outpatient programmes. Further randomized controlled (cost-)effectiveness research is necessary to substantiate these findings and investigate the specific patient populations for which day treatment is essential.
OBJECTIVE: This study aimed to investigate the effectiveness of day treatment GST for patients with PDs.
METHODS: Negative core beliefs were the primary outcome in a multiple baseline single-case design, measured weekly before and during 30 weeks of day treatment GST. Secondary outcomes included severity of primary PD, early maladaptive schemas (EMS), schema modes and general psychopathology measured before and after day treatment GST. Intervention effects were evaluated through visual inspection and randomization test analysis, with a reliable change index calculated for the secondary outcome measures.
RESULTS: A total of 79% of treatment completers showed a significant positive effect of day treatment GST with large effect sizes (Cohen\'s d: 0.96-10.04). Secondary outcomes supported these findings: 56% had a significant decrease in the severity of primary PD and 53% in general psychopathology. In addition, 63% of EMS and 72% of schema modes (87.5% for functional schema modes) showed significant positive reliable changes.
CONCLUSIONS: This is the first empirical study that demonstrated the effectiveness of day treatment GST in patients with severe PDs. Day treatment GST can serve as a stepped care treatment option for nonresponsive patients in outpatient programmes. Further randomized controlled (cost-)effectiveness research is necessary to substantiate these findings and investigate the specific patient populations for which day treatment is essential.
摘要：
背景：图式治疗对大多数患有人格障碍（PD）的门诊患者有效。然而,一个亚组不能充分受益于门诊方案.尽管其临床用途普遍，缺乏对日间治疗组方案治疗(GST)的全面评估.
目的：本研究旨在探讨日间GST治疗对PDs患者的有效性。
方法：负面核心信念是多基线单病例设计的主要结果，在治疗前和治疗30周内每周测量GST。次要结果包括原发性PD的严重程度，早期适应不良模式(EMS)，在治疗前和治疗后测量的模式模式和一般精神病理学GST。通过目测和随机化测试分析评价干预效果,为次要结局指标计算可靠的变化指数。
结果：总共79％的治疗完成者显示出具有较大效应大小的日治疗GST的显着正效应（Cohen'sd：0.96-10.04）。次要结果支持这些发现：56％的原发性PD严重程度显着降低，而53％的普通精神病理学降低。此外,63％的EMS和72％的模式模式（功能模式为87.5％）显示出显着的积极可靠变化。
结论：这是首次实证研究，证明了日治疗GST对重度PD患者的有效性。日间治疗GST可以作为门诊计划中无反应患者的阶梯式护理治疗选择。进一步的随机对照（成本）有效性研究是必要的，以证实这些发现，并调查特定的患者群体，这一天的治疗是必要的。
目的：本研究旨在探讨日间GST治疗对PDs患者的有效性。
方法：负面核心信念是多基线单病例设计的主要结果，在治疗前和治疗30周内每周测量GST。次要结果包括原发性PD的严重程度，早期适应不良模式(EMS)，在治疗前和治疗后测量的模式模式和一般精神病理学GST。通过目测和随机化测试分析评价干预效果,为次要结局指标计算可靠的变化指数。
结果：总共79％的治疗完成者显示出具有较大效应大小的日治疗GST的显着正效应（Cohen'sd：0.96-10.04）。次要结果支持这些发现：56％的原发性PD严重程度显着降低，而53％的普通精神病理学降低。此外,63％的EMS和72％的模式模式（功能模式为87.5％）显示出显着的积极可靠变化。
结论：这是首次实证研究，证明了日治疗GST对重度PD患者的有效性。日间治疗GST可以作为门诊计划中无反应患者的阶梯式护理治疗选择。进一步的随机对照（成本）有效性研究是必要的，以证实这些发现，并调查特定的患者群体，这一天的治疗是必要的。
