Eva K Horn1,2, Anna Bartak3,4, Anke M M A Meerman5, Bert V Rossum6, Uli M Ziegler7, Moniek Thunnissen8,9, Mirjam Soons10, Helene Andrea11,12, Elisabeth F M Hamers13, Paul M G Emmelkamp3,14, Theo Stijnen15, Jan J V Busschbach1,2, Roel Verheul3,13. 1. Viersprong Institute for Studies on Personality Disorders (VISPD), Bergen op Zoom, The Netherlands. 2. Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands. 3. Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands. 4. Bos en Lommer Private Practice, Amsterdam, The Netherlands. 5. Center of Psychotherapy Pro Persona, Lunteren, The Netherlands. 6. Altrecht, Zeist, The Netherlands. 7. Zaans Medical Center, Zaandam, The Netherlands. 8. GGZ WNB, Bergen op Zoom, The Netherlands. 9. Private Practice, Bergen op Zoom, The Netherlands. 10. Arkin, Amsterdam, The Netherlands. 11. GGZ Breburg, Tilburg, The Netherlands. 12. Tranzo Scientific Centre for Care and Welfare, Faculty of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands. 13. De Viersprong, Netherlands Institute for Personality Disorders, Halsteren, The Netherlands. 14. The Center for Social and Humanities Research, King Abdulaziz University, Jeddah, Saudi Arabia. 15. Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands.
Abstract
OBJECTIVE: Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy. METHOD: A total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups. RESULTS: All treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished. CONCLUSION: Patients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness. KEY PRACTITIONER MESSAGES: The effectiveness of different modalities of psychotherapy in patients with PDNOS (i.e., short-term vs long-term; outpatient versus day hospital versus inpatient psychotherapy) has not yet been compared. Different modalities of psychotherapy are effective for patients with PDNOS, and positive effects remain after 5 years. In patients with PDNOS short-term (less than 6 months) outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the four other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness.
OBJECTIVE: Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy. METHOD: A total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups. RESULTS: All treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished. CONCLUSION: Patients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness. KEY PRACTITIONER MESSAGES: The effectiveness of different modalities of psychotherapy in patients with PDNOS (i.e., short-term vs long-term; outpatient versus day hospital versus inpatient psychotherapy) has not yet been compared. Different modalities of psychotherapy are effective for patients with PDNOS, and positive effects remain after 5 years. In patients with PDNOS short-term (less than 6 months) outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the four other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness.
Authors: Sarah Ledden; Luke Sheridan Rains; Merle Schlief; Phoebe Barnett; Brian Chi Fung Ching; Brendan Hallam; Mia Maria Günak; Thomas Steare; Jennie Parker; Sarah Labovitch; Sian Oram; Steve Pilling; Sonia Johnson Journal: BMC Psychiatry Date: 2022-09-05 Impact factor: 4.144
Authors: Géza Kovács; Annemiek van Dijke; Roeslan Leontjevas; Marie-José Enders-Slegers Journal: Int J Environ Res Public Health Date: 2022-08-30 Impact factor: 4.614