Mike J Crawford1, Lavanya Thana2, Jennie Parker2, Oliver Turner3, Aidan Carney4, Mary McMurran5, Paul Moran6, Timothy Weaver7, Barbara Barrett8, Sarah Roberts8, Amy Claringbold1, Paul Bassett9, Rahil Sanatinia1, Amanda Spong10. 1. Division of Psychiatry, Imperial College London, UK. 2. Research and Development, Central & North West London NHS Foundation Trust, UK. 3. Division of Specialist Services, Barnet, Enfield & Haringey NHS Trust, UK. 4. Adult Mental Health Directorate, Central & North West London NHS Foundation Trust, UK. 5. Psychiatry and Applied Psychology Department, University of Nottingham, UK. 6. Centre for Academic Mental Health, University of Bristol, UK. 7. School of Health and Education, Middlesex University London, UK. 8. Health Service and Population Research, King's College London, UK. 9. Statsconsultancy Ltd, UK. 10. Clinical Psychology, Cambridgeshire and Peterborough NHS Foundation Trust, UK.
Abstract
BACKGROUND:National guidance cautions against low-intensity interventions for people with personality disorder, but evidence from trials is lacking. AIMS: To test the feasibility of conducting a randomised trial of a low-intensity intervention for people with personality disorder. METHOD: Single-blind, feasibility trial (trial registration: ISRCTN14994755). We recruited people aged 18 or over with a clinical diagnosis of personality disorder from mental health services, excluding those with a coexisting organic or psychotic mental disorder. We randomly allocated participants via a remote system on a 1:1 ratio to six to ten sessions of Structured Psychological Support (SPS) or to treatment as usual. We assessed social functioning, mental health, health-related quality of life, satisfaction with care and resource use and costs at baseline and 24 weeks after randomisation. RESULTS: A total of 63 participants were randomly assigned to either SPS (n = 33) or treatment as usual (n = 30). Twenty-nine (88%) of those in the active arm of the trial received one or more session (median 7). Among 46 (73%) who were followed up at 24 weeks, social dysfunction was lower (-6.3, 95% CI -12.0 to -0.6, P = 0.03) and satisfaction with care was higher (6.5, 95% CI 2.5 to 10.4; P = 0.002) in those allocated to SPS. Statistically significant differences were not found in other outcomes. The cost of the intervention was low and total costs over 24 weeks were similar in both groups. CONCLUSIONS:SPS may provide an effective low-intensity intervention for people with personality disorder and should be tested in fully powered clinical trials.
RCT Entities:
BACKGROUND: National guidance cautions against low-intensity interventions for people with personality disorder, but evidence from trials is lacking. AIMS: To test the feasibility of conducting a randomised trial of a low-intensity intervention for people with personality disorder. METHOD: Single-blind, feasibility trial (trial registration: ISRCTN14994755). We recruited people aged 18 or over with a clinical diagnosis of personality disorder from mental health services, excluding those with a coexisting organic or psychotic mental disorder. We randomly allocated participants via a remote system on a 1:1 ratio to six to ten sessions of Structured Psychological Support (SPS) or to treatment as usual. We assessed social functioning, mental health, health-related quality of life, satisfaction with care and resource use and costs at baseline and 24 weeks after randomisation. RESULTS: A total of 63 participants were randomly assigned to either SPS (n = 33) or treatment as usual (n = 30). Twenty-nine (88%) of those in the active arm of the trial received one or more session (median 7). Among 46 (73%) who were followed up at 24 weeks, social dysfunction was lower (-6.3, 95% CI -12.0 to -0.6, P = 0.03) and satisfaction with care was higher (6.5, 95% CI 2.5 to 10.4; P = 0.002) in those allocated to SPS. Statistically significant differences were not found in other outcomes. The cost of the intervention was low and total costs over 24 weeks were similar in both groups. CONCLUSIONS:SPS may provide an effective low-intensity intervention for people with personality disorder and should be tested in fully powered clinical trials.
Authors: Kylee Trevillion; Ruth Stuart; Josephine Ocloo; Eva Broeckelmann; Stephen Jeffreys; Tamar Jeynes; Dawn Allen; Jessica Russell; Jo Billings; Mike J Crawford; Oliver Dale; Rex Haigh; Paul Moran; Shirley McNicholas; Vicky Nicholls; Una Foye; Alan Simpson; Brynmor Lloyd-Evans; Sonia Johnson; Sian Oram Journal: BMC Psychiatry Date: 2022-01-27 Impact factor: 3.630