BackgroundDialectical behavior therapy has demonstrated effectiveness for patients suffering from co-morbid borderline personality and substance use disorder. The current study tries to replicate results of previous studies in a mixed gender sample of Egyptian outpatients.AimThe aim of the current study was to examine the effectiveness of DBT without drug replacement relative to treatment as usual “TAU” in improving behavioral outcomes related to SUD and BPD, and improving emotional regulation.MethodsForty outpatients with co-morbid BPD and SUD in Alexandria and Cairo were assigned for one year either to comprehensive DBT program (20 patients), or TAU defined as ongoing outpatient psychotherapeutic treatment from referring center (20 patients). Patients were assessed at baseline and follow up assessment at 4, 8, 12 and 16 months was done using Arabic version of Difficulties in Emotion Regulation Scale (DERS), urine multidrug screen and time line follow-back method for assessment of alcohol and substance use history.ResultsFollowing one year of treatment, DBT group showed significantly lower doses of drugs used, DERS score, rates of hospital admission, ER visits, suicidal attempts and episodes of NSSI. Also, DBT patients showed markedly increased retention in treatment and longer duration of total alcohol abstinence and other drugs of abuse. Positive outcomes were maintained for four months post-treatment.ConclusionDBT demonstrated superior efficacy in comparison to TAU for treatment of Egyptian patients suffering from co-morbid borderline personality and substance use disorder across behavioral domains of SUD, BPD and reduction hospital admission, emergency room visits and DERS score.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Background: Divorce rates have increased during the last decade, leading to a greater focus of marital scholars on the importance of understanding couple-maintaining strategies within marital life. Distresses in couples are attributable to difficulties controlling felt, experienced, and expressed emotions; thus, emotion dysregulation is a core stressor in couples with maladaptive responses. Objective: The aim of the study was to evaluate the effect of Dialectical Behaviour Therapy (DBT) on outpatient couples to treat emotion dysregulation. Methods: We recruited 20 couples with marital distress in which partners presented emotion dysregulation. We offered the couples the opportunity to join a couple DBT group at their convenience and based on the immediate availability of treatment slots. We measured the treatment efficacy using psychometric tools (the Difficulties in Emotion Regulation Scale (DERS) and the Dyadic Adjustment Ccale (DAS) at baseline and after DBT therapy. Results: Both male and female partners presented significant improvements in marital adjustment DAS and emotion regulation scores. Female partners showed significantly greater amplitude changes in both scales. Female partners showed significant improvement in most DERS subscales (except the GOALS subscale); on the other hand, male partners showed significant improvements in impulse, awareness, strategies, and clarity subscales. We found significant improvements in most DAS subscales in both sexes; only affectional expression remained unchanged before and after therapy. Conclusion: DBT for couples is an effective approach to treat emotion dysregulation.

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Background: Psychogenic nonepileptic seizures (PNES) are major challenges for diagnosis and management. The heterogeneity of psychogenic seizures is attributed to diverse psychopathological comorbidities, and the causal relationship between PNES and underlying psychopathologies is still enigmatic. Objective: Our objective was to study psychiatric comorbidities and personality constructs in patients with PNES and compare them to a control group of patients with epilepsy. Method: We randomly recruited 33 patients with PNES and 33 patients with epilepsy. All patients completed the Mini-International Neuropsychiatric Interview (MINI) to screen for psychiatric comorbidities, the Structured Clinical Interview for psychiatric disorders in Axis II (SCID II) to screen for personality disorders, and Goldberg's International Personality Item Pool (IPIP) Big Five personality questionnaire to study the psychological constructs of extroversion-introversion, agreeableness, conscientiousness, emotional stability-neuroticism, and intellect. Result: Mood and anxiety disorders were highly prevalent in patients with PNES (72.7% and 54.5%, respectively); however, the prevalence of only cluster B personality disorder was higher in patients with PNES (69.7%) compared to 33.3% among patients with epilepsy (p < 0.05). Screening for personality disorders using SCID II showed that the prevalence of borderline and depressive personality disorders was significantly higher in patients with PNES (p < 0.001). Patients with psychogenic seizures were more likely to be receiving polydrug therapy (75.8%) compared to patients with epileptic seizures (45.5%); this difference was statistically significant (p < 0.05). Conclusion: Psychiatric comorbidities are highly prevalent among patients with PNES.

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