Literature DB >> 23637110

Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial.

Rohan Borschmann1, Barbara Barrett, Jennifer M Hellier, Sarah Byford, Claire Henderson, Diana Rose, Mike Slade, Kim Sutherby, George Szmukler, Graham Thornicroft, Joanna Hogg, Paul Moran.   

Abstract

BACKGROUND: People with borderline personality disorder frequently experience crises. To date, no randomised controlled trials (RCTs) of crisis interventions for this population have been published. AIMS: To examine the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot RCT investigating the potential efficacy and cost-effectiveness of using a joint crisis plan.
METHOD: An RCT of joint crisis plans for community-dwelling adults with borderline personality disorder (trial registration: ISRCTN12440268). The primary outcome measure was the occurrence of self-harming behaviour over the 6-month period following randomisation. Secondary outcomes included depression, anxiety, engagement and satisfaction with services, quality of life, well-being and cost-effectiveness.
RESULTS: In total, 88 adults out of the 133 referred were eligible and were randomised to receive a joint crisis plan in addition to treatment as usual (TAU; n = 46) or TAU alone (n = 42). This represented approximately 75% of our target sample size and follow-up data were collected on 73 (83.0%) participants. Intention-to-treat analysis revealed no significant differences in the proportion of participants who reported self-harming (odds ratio (OR) = 1.9, 95% CI 0.53-6.5, P = 0.33) or the frequency of self-harming behaviour (rate ratio (RR) = 0.74, 95% CI 0.34-1.63, P = 0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures or costs.
CONCLUSIONS: It is feasible to recruit and retain people with borderline personality disorder to a trial of joint crisis plans and the intervention appears to have high face validity with this population. However, we found no evidence of clinical efficacy in this feasibility study.

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Year:  2013        PMID: 23637110     DOI: 10.1192/bjp.bp.112.117762

Source DB:  PubMed          Journal:  Br J Psychiatry        ISSN: 0007-1250            Impact factor:   9.319


  19 in total

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Review 3.  Crisis interventions for adults with borderline personality disorder.

Authors:  Jonathan Monk-Cunliffe; Rohan Borschmann; Alice Monk; Joanna O'Mahoney; Claire Henderson; Rachel Phillips; Jonathan Gibb; Paul Moran
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4.  Joint crisis planning in mental health care: the challenge of implementation in randomized trials and in routine care.

Authors:  Claire Henderson; Simone Farrelly; Paul Moran; Rohan Borschmann; Graham Thornicroft; Max Birchwood; The Crimson
Journal:  World Psychiatry       Date:  2015-10       Impact factor: 49.548

5.  The clinical effectiveness and cost effectiveness of clozapine for inpatients with severe borderline personality disorder (CALMED study): a randomised placebo-controlled trial.

Authors:  Mike J Crawford; Verity C Leeson; Rachel Evans; Barbara Barrett; Aisling McQuaid; Jack Cheshire; Rahil Sanatinia; Gary Lamph; Piyal Sen; Katina Anagnostakis; Louise Millard; Inti Qurashi; Fintan Larkin; Nusrat Husain; Paul Moran; Thomas R E Barnes; Carol Paton; Zoe Hoare; Marco Picchioni; Simon Gibbon
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6.  Psychological therapies for people with borderline personality disorder.

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7.  Lamotrigine versus inert placebo in the treatment of borderline personality disorder: study protocol for a randomized controlled trial and economic evaluation.

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Review 8.  A systematic review of economic evaluations of treatments for borderline personality disorder.

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9.  Informed, advance refusals of treatment by people with severe mental illness in a randomised controlled trial of joint crisis plans: demand, content and correlates.

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Journal:  BMC Psychiatry       Date:  2017-11-24       Impact factor: 3.630

10.  Preventing Compulsory Admission to Psychiatric Inpatient Care: Perceived Coercion, Empowerment, and Self-Reported Mental Health Functioning after 12 Months of Preventive Monitoring.

Authors:  Barbara Lay; Thekla Drack; Marco Bleiker; Silke Lengler; Christina Blank; Wulf Rössler
Journal:  Front Psychiatry       Date:  2015-11-18       Impact factor: 4.157

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