Le trouble de la personnalité limite (TPL) est caractérisé par une importante impulsivité ainsi qu’une instabilité de l’image de soi, des émotions et des relations. Les proches d’individus TPL sont souvent considérés comme des victimes face aux difficultés relationnelles auxquelles ils sont confrontés. Pour cette raison, un modèle original diffusé au Québec, fondé notamment sur les principes de Thérapie comportementale dialectique (TCD), a été développé pour les proches. Notre objectif est d’évaluer l’efficacité de ce modèle et de fournir des données préliminaires sur le sujet.

Cette étude porte sur 56 participants recrutés dans des organismes communautaires offrant du support aux proches de personnes atteintes d’un trouble mental. Les participants ont pris part à des séances de psychoéducation visant à implanter un changement dans leurs dynamiques relationnelles et de vie.

Les résultats montrent une réduction statistiquement significative de la majorité des 9 variables de l’échelle SCL-90-R (p<0,01), avec des tailles d’effet (d de Cohen) les plus élevées pour les variables de dépression (0,65) et d’anxiété (0,58).

Au final, cette étude confirme que les proches de personnes TPL présentent une souffrance clinique sur différents niveaux psychopathologiques. Ensuite, nos résultats suggèrent que l’intervention est pertinente et parvient à réduire l’intensité de la détresse psychologique.

Des études contrôlées et comparatives sont nécessaires afin de confirmer l’efficacité du modèle de traitement.

Borderline personality disorder (BPD) is characterized by an instability in subjects’ self-image, emotions, and relationships, along with impulsivity. Relatives of individuals with this diagnosis are often looked at as victims of this instability. In fact, many studies report a significant impact of BPD on their loved ones in terms of emotional and physical health, as well as on their social lives. Knowing that BPD is diagnosed in up to 2% of the population, the impact of this disorder affects hundreds of thousands of people across the world. Therefore, an intervention tailored for relatives of individuals with BPD is of great importance in order to limit the impact of the disorder on themselves. For this reason, an original model distributed in Quebec, based on the principles of Dialectical Behavioral Therapy (DBT) has been developed. Our goal is to evaluate the effectiveness of this model and to provide additional preliminary information on the subject.

This study focuses on 56 relatives recruited from support groups in community organizations providing help for relatives of persons with mental disorders. Recruitment was conducted in nine community organizations located in nine different cities in the province of Quebec. These organizations, located in urban or rural areas, all offered support groups to relatives of individuals with BPD. These relatives participated in 10 to 16 sessions of therapy, separated into two modules and that make use of the skills taught in the original DBT. First, weekly group sessions aimed at educating relatives on BPD and relational dynamics, followed by other individual or group sessions aiming to implement change in their relational and life dynamics. We used the Symptom Checklist-90-R (SCL-90-R) to assess the psychological distress of the 56 participants pre- and post-intervention.

The results show a statistically significant reduction of the majority of the nine variables of the SCL-90-R scale (p<0.01), with the highest effect sizes for the variables of depression (0.65) and anxiety (0.58). We also observe a statistically significant reduction (p<0.01) of the global score on SCL-90-R with a result of 44.92 (SD: 30.69) post-intervention instead of 68.81 (SD: 51.14) at baseline. A moderate effect size was obtained for the global score after the intervention (0.57).

Results support the notion that relatives of individuals with reported BPD present significant distress on different psychopathological sub-scales. Next, our findings suggest that DBT intervention may be highly relevant, and sustainable, in the reduction of the intensity of psychological distress.

Controlled and comparative studies are needed to confirm our results. Furthermore, it would be interesting to assess what impact the reduction of psychological distress of relatives may have on the subjects with BPD themselves.