Luyten, PJ;
Laurenssen, EMP;
Kikkert, MJ;
Westra, D;
Peen, J;
Soons, MBJ;
van Dam, AM;
... Dekker, JJM; + view all
(2018)
Day Hospital Mentalization-Based Treatment versus Specialist Treatment As Usual in Patients with Borderline Personality Disorder: Randomized Controlled Trial.
Psychological Medicine
, 48
(15)
pp. 2522-2529.
10.1017/S0033291718000132.
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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 versus 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 on 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 versus S-TAU, reflected in significantly higher early drop-out rates in S-TAU (34%) versus MBT-DH (9%). Conclusions. Contrary to our expectations, MBT-DH was not superior to S-TAU 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.
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