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Day hospital versus intensive out-patient mentalisation-based treatment for borderline personality disorder:Multicentre randomised clinical trial
- Source :
- Smits, M L, Feenstra, DI J, Eeren, H V, Bales, D L, Laurenssen, E M P, Blankers, M, Soons, M B J, Dekker, J J M, Lucas, Z, Verheul, R & Luyten, P 2020, ' Day hospital versus intensive out-patient mentalisation-based treatment for borderline personality disorder : Multicentre randomised clinical trial ', British Journal of Psychiatry, vol. 216, no. 2, pp. 79-84 . https://doi.org/10.1192/bjp.2019.9, British Journal of Psychiatry, 216(2), 79-84. Royal College of Psychiatrists
- Publication Year :
- 2020
-
Abstract
- BackgroundTwo types of mentalisation-based treatment (MBT) have been developed and empirically evaluated for borderline personality disorder (BPD): day hospital MBT (MBT-DH) and intensive out-patient MBT (MBT-IOP). No trial has yet compared their efficacy.AimsTo compare the efficacy of MBT-DH and MBT-IOP 18 months after start of treatment. MBT-DH was hypothesised to be superior to MBT-IOP because of its higher treatment intensity.MethodIn a multicentre randomised controlled trial (Nederlands Trial Register: NTR2292) conducted at three sites in the Netherlands, patients with BPD were randomly assigned to MBT-DH (n = 70) or MBT-IOP (n = 44). The primary outcome was symptom severity (Brief Symptom Inventory). Secondary outcome measures included borderline symptomatology, personality functioning, interpersonal functioning, quality of life and self-harm. Patients were assessed every 6 months from baseline to 18 months after start of treatment. Data were analysed using multilevel modelling based on intention-to-treat principles.ResultsSignificant improvements were found on all outcome measures, with moderate to very large effect sizes for both groups. MBT-DH was not superior to MBT-IOP on the primary outcome measure, but MBT-DH showed a clear tendency towards superiority on secondary outcomes.ConclusionsAlthough MBT-DH was not superior to MBT-IOP on the primary outcome measure despite its greater treatment intensity, MBT-DH showed a tendency to be more effective on secondary outcomes, particularly in terms of relational functioning. Patients receiving MBT-DH and MBT-IOP, thus, seem to follow different trajectories of change, which may have important implications for clinical decision-making. Longer-term follow-up and cost-effectiveness considerations may ultimately determine the optimal intensity of specialised treatments such as MBT for patients with BPD.
- Subjects :
- Male
050103 clinical psychology
Every Six Months
Mentalisation-Based Treatment
law.invention
0302 clinical medicine
Quality of life
Randomized controlled trial
law
Borderline Personality Disorder
Outpatients
Medicine
Borderline personality disorder
media_common
Netherlands
Psychiatry
05 social sciences
Justice and Strong Institutions
Hospitals
Psychiatry and Mental health
Treatment Outcome
embryonic structures
Day hospital
Female
Life Sciences & Biomedicine
Adult
medicine.medical_specialty
SDG 16 - Peace
animal structures
media_common.quotation_subject
18-MONTH
03 medical and health sciences
Mentalization
PSYCHOTHERAPY
Personality
Mentalization-based treatment
Humans
0501 psychology and cognitive sciences
Science & Technology
business.industry
MENTALIZATION-BASED TREATMENT
SDG 16 - Peace, Justice and Strong Institutions
treatment intensity
medicine.disease
030227 psychiatry
Clinical trial
randomized controlled trial
Physical therapy
Quality of Life
FOLLOW-UP
business
Self-Injurious Behavior
borderline personality disorder
Subjects
Details
- Language :
- English
- ISSN :
- 00071250
- Database :
- OpenAIRE
- Journal :
- Smits, M L, Feenstra, DI J, Eeren, H V, Bales, D L, Laurenssen, E M P, Blankers, M, Soons, M B J, Dekker, J J M, Lucas, Z, Verheul, R & Luyten, P 2020, ' Day hospital versus intensive out-patient mentalisation-based treatment for borderline personality disorder : Multicentre randomised clinical trial ', British Journal of Psychiatry, vol. 216, no. 2, pp. 79-84 . https://doi.org/10.1192/bjp.2019.9, British Journal of Psychiatry, 216(2), 79-84. Royal College of Psychiatrists
- Accession number :
- edsair.doi.dedup.....9a0de71b998cb2b278e08d6c0479721e