Assessment of Cost-effectiveness in Two Empirically-based Psychotherapies for Borderline Personality Disorder: A Randomized Controlled Trial

NCT04309045 | Unknown

• 1 other identifier: 0011-19-SHA
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

Patients suffering from borderline personality disorder (BPD) are considered frequent utilizers of psychiatric emergency rooms and of psychiatric hospitalizations. Nonetheless, recent studies challenge the effectiveness of psychiatric hospitalizations in reducing BPD symptoms, and some have even indicated potentially harmful effects such as increasing suicide risk post-discharge. These findings highlight the importance of effective outpatient treatments for BPD patients in public psychiatric hospital settings. In this study we aim to assess the effectiveness and cost-effectiveness of two empirically-based treatments for BPD: dialectical behavior therapy (DBT) and dynamic deconstructive psychotherapy (DDP).

Conditions

Treatment 1:Dialectical Behavior Therapy (DBT); Treatment 2:Dynamic Deconstructive Psychotherapy (DDP); Placebo

Outcome Measures

Primary Outcomes (1)

• Incremental cost-effectiveness ratio (ICER)

  The measure will be assessed by comparing health care use costs in ratio to improvement on the Columbia hardware rating scale.

  The expected duration of treatment is about one year

Study Arms (3)

DBT

EXPERIMENTAL

Standard DBT treatment

Behavioral: DBT

DDP

ACTIVE COMPARATOR

dynamic deconstructive psychotherapy (DDP) treatment, is part of a trend of dynamic therapies to treat borderline personality disorder. DDP is a treatment specifically developed for a population with more severe symptoms those dealing with borderline personality disorder.

Behavioral: DDP

control group

PLACEBO COMPARATOR

patients on the waiting list for treatment, or patients in the hospital under routine care. Which will form the control group.

Other: control group

Interventions

DBT BEHAVIORAL

Today, the most well-known and established treatment for borderline personality disorder is Dialectical Behavior Therapy (DBT) that developed by Marsha Linhan in the 1990s. DBT is currently used in other disorders such as: eating disorders, addictions, impulse control problems and bipolar disorder. Various studies have found a beneficial effect for this treatment in various areas: decreased suicidal thoughts and attempts and self-harm behaviors, improvements in suicide attempts, anger levels, impulsive behaviors, depressive symptoms, The use of drugs, the percentage of dropouts from treatment, number Hospitalization and general function.

DBT

DDP BEHAVIORAL

DDP treatment is part of a trend of dynamic therapies to treat borderline personality disorder. The DDP focuses on deficiencies in the emotional experience processing and is performed in the form of weekly, individual sessions with a trained therapist over a 12-18 month period. Treatment is based on the need to correct three neurocognitive functions responsible for adaptive processing of emotional experiences: association (the ability to recognize, understand their existence, and experience a sequence of emotional experiences), attribution (the ability to make complex attributions about the self and others), and the ability to make realistic attribution, about the self and the other. Interventions that activate these three functions are the basis for DDP treatment.

DDP

control group OTHER

Patients on the waiting list for treatment, or patients in the hospital under routine care.

control group

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• between 18 and 45 years old
• diagnosis of BPD,
• history of a suicide attempt within the prior year with presence of current suicidal ideation,
• agrees to participate in psychotherapy
• signed informed consent,

You may not qualify if:

• meet diagnostic criteria for schizophrenia, schizoaffective disorders, or have severe intellectual impairment.

Sponsors & Collaborators

• Shalvata Mental Health Center: lead

MeSH Terms

Interventions

Control Groups

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Research Design; Methods

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: March 12, 2020
• First Posted: March 16, 2020
• Study Start: April 1, 2020
• Primary Completion: October 22, 2024
• Study Completion: October 22, 2024
• Last Updated: March 16, 2020

Record last verified: 2020-03