Fernando Lana1, Carmen Sánchez-Gil2, Laia Ferrer3, Nuria López-Patón4, Lia Litvan2, Susana Marcos2, Ana C Sierra5, Joan M Soldevilla6, Guillem Feixas6, Víctor Pérez2. 1. Instituto de Neuropsiquiatría y Adicciones (INAD), Parc de Salut Mar, Centro de Investigación en Red de Salud Mental (CIBERSAM), Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: Flanamoliner@parcdesalutmar.cat. 2. Instituto de Neuropsiquiatría y Adicciones (INAD), Parc de Salut Mar, Centro de Investigación en Red de Salud Mental (CIBERSAM), Universidad Autónoma de Barcelona, Barcelona, España. 3. Centro de Salud Mental Infantil y Juvenil de Santa Coloma de Gramenet, Fundación Vidal i Barraquer, Santa Coloma de Gramenet, Barcelona, España. 4. Centro de Salud Mental Infantil y Juvenil de Granollers, Servei de Salut Mental, Hospital Sant Joan de Déu, Granollers, Barcelona, España. 5. Hospital Miguel Servet, Sector II, Zaragoza, España. 6. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Barcelona, Barcelona, España.
Abstract
INTRODUCTION: Over the past 25 years, several studies have shown the efficacy of a number of psychological interventions for severe personality disorders. However, the generalizability of these positive results from long traditional research settings to more ordinary ones has been questioned, requiring a need for replication in pragmatic studies. METHODS: This pragmatic study compares hospitalizations and Emergency Room visits before and during a 6-month therapeutic program for severe personality disorders, and at 36 months after starting it. The therapeutic program, which integrates several specific interventions within a coherent framework, was carried out in an ordinary clinical setting. Fifty-one patients, evaluated according DSM-IV criteria by using the Spanish version of the Structured Clinical Interview for Personality Disorders (SCID-II), were included. RESULTS: The clinical characteristics showed a group of severely disturbed patients, of which 78.4% met criteria for borderline personality disorder. The percentage of patients hospitalized and visiting the Emergency Room, as well as the number of days of hospitalization and Emergency Room visits was significantly reduced during the treatment, and this improvement was maintained throughout. CONCLUSIONS: An integrated treatment for severe personality disorders could be effective in preventing reliance on readmissions, or prolonged hospital stays, when it is implemented by clinicians in ordinary clinical settings.
INTRODUCTION: Over the past 25 years, several studies have shown the efficacy of a number of psychological interventions for severe personality disorders. However, the generalizability of these positive results from long traditional research settings to more ordinary ones has been questioned, requiring a need for replication in pragmatic studies. METHODS: This pragmatic study compares hospitalizations and Emergency Room visits before and during a 6-month therapeutic program for severe personality disorders, and at 36 months after starting it. The therapeutic program, which integrates several specific interventions within a coherent framework, was carried out in an ordinary clinical setting. Fifty-one patients, evaluated according DSM-IV criteria by using the Spanish version of the Structured Clinical Interview for Personality Disorders (SCID-II), were included. RESULTS: The clinical characteristics showed a group of severely disturbed patients, of which 78.4% met criteria for borderline personality disorder. The percentage of patients hospitalized and visiting the Emergency Room, as well as the number of days of hospitalization and Emergency Room visits was significantly reduced during the treatment, and this improvement was maintained throughout. CONCLUSIONS: An integrated treatment for severe personality disorders could be effective in preventing reliance on readmissions, or prolonged hospital stays, when it is implemented by clinicians in ordinary clinical settings.
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