Elisabeth M P Laurenssen1, Patrick Luyten2, Martijn J Kikkert3, Dieuwertje Westra4, Jaap Peen3, Mirjam B J Soons5, Anne-Marie van Dam6, Anna J van Broekhuyzen7, Matthijs Blankers3, Jan J V Busschbach8, Jack J M Dekker3. 1. Dutch Knowledge Centre for Child and Adolescent Psychiatry,Utrecht,The Netherlands. 2. Faculty of Psychology and Educational Sciences,University of Leuven,Belgium;Research Department of Clinical, Educational and Health Psychology,University College London,UK. 3. Department of Research,Arkin Mental Health Care,Amsterdam,The Netherlands. 4. Arkin Mental Health Care,Amsterdam,The Netherlands. 5. NPI Specialist in Personality Problems,Amsterdam,The Netherlands. 6. Mentrum,Amsterdam,The Netherlands. 7. De Viersprong,Amsterdam,The Netherlands. 8. Department of Psychiatry,Section Medical Psychology and Psychotherapy,Erasmus MC, Rotterdam,The Netherlands.
Abstract
BACKGROUND:Day hospital mentalization-based treatment (MBT-DH) is a promising treatment for borderline personality disorder (BPD) but its evidence base is still limited. This multi-site randomized trial compared the efficacy of MBT-DH delivered by a newly set-up service v. specialist treatment as usual (S-TAU) tailored to the individual needs of patients, and offered by a well-established treatment service. METHODS:Two mental healthcare institutes in The Netherlands participated in the study. Patients who met DSM-IV criteria for BPD and had a score of ⩾20 on the borderline personality disorder severity index (BPDSI) were randomly allocated to MBT-DH (N = 54) or S-TAU (N = 41). The primary outcome variable was the total score on the BPDSI. Secondary outcome variables included symptom severity, quality of life, and interpersonal functioning. Data were collected at baseline and every 6 months until 18-month follow-up, and were analyzed using multilevel analyses based on intention-to-treat principles. RESULTS: Both treatments were associated with significant improvements in all outcome variables. MBT-DH was not superior to S-TAU on any outcome variable. MBT-DH was associated with higher acceptability in BPD patients compared v. S-TAU, reflected in significantly higher early drop-out rates in S-TAU (34%) v. MBT-DH (9%). CONCLUSIONS:MBT-DH delivered by a newly set-up service is as effective as specialist TAU in The Netherlands in the treatment of BPD at 18-month follow-up. Further research is needed to investigate treatment outcomes in the longer term and the cost-effectiveness of these treatments.
RCT Entities:
BACKGROUND: Day hospital mentalization-based treatment (MBT-DH) is a promising treatment for borderline personality disorder (BPD) but its evidence base is still limited. This multi-site randomized trial compared the efficacy of MBT-DH delivered by a newly set-up service v. specialist treatment as usual (S-TAU) tailored to the individual needs of patients, and offered by a well-established treatment service. METHODS: Two mental healthcare institutes in The Netherlands participated in the study. Patients who met DSM-IV criteria for BPD and had a score of ⩾20 on the borderline personality disorder severity index (BPDSI) were randomly allocated to MBT-DH (N = 54) or S-TAU (N = 41). The primary outcome variable was the total score on the BPDSI. Secondary outcome variables included symptom severity, quality of life, and interpersonal functioning. Data were collected at baseline and every 6 months until 18-month follow-up, and were analyzed using multilevel analyses based on intention-to-treat principles. RESULTS: Both treatments were associated with significant improvements in all outcome variables. MBT-DH was not superior to S-TAU on any outcome variable. MBT-DH was associated with higher acceptability in BPD patients compared v. S-TAU, reflected in significantly higher early drop-out rates in S-TAU (34%) v. MBT-DH (9%). CONCLUSIONS:MBT-DH delivered by a newly set-up service is as effective as specialist TAU in The Netherlands in the treatment of BPD at 18-month follow-up. Further research is needed to investigate treatment outcomes in the longer term and the cost-effectiveness of these treatments.
Authors: Mie Sedoc Jørgensen; Ole Jakob Storebø; Sune Bo; Stig Poulsen; Matthias Gondan; Emma Beck; Andrew M Chanen; Anthony Bateman; Jesper Pedersen; Erik Simonsen Journal: Eur Child Adolesc Psychiatry Date: 2020-05-09 Impact factor: 4.785
Authors: Ole Jakob Storebø; Jutta M Stoffers-Winterling; Birgit A Völlm; Mickey T Kongerslev; Jessica T Mattivi; Mie S Jørgensen; Erlend Faltinsen; Adnan Todorovac; Christian P Sales; Henriette E Callesen; Klaus Lieb; Erik Simonsen Journal: Cochrane Database Syst Rev Date: 2020-05-04
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