Evaluation of a Dimensional Adaptation of Good Psychiatric Management (GPM-extended) for the Treatment of Borderline Personality Disorder
EPSYLIA
A Pragmatic Non-randomized Controlled Study Evaluating the Efficacy of a Dimensional Adaptation of Good Psychiatric Management (GPM-extended) Compared to a Classic Outpatient Good Psychiatric Management Treatment for Patient Fulfilling Criteria for Borderline Personality Disorder
1 other identifier
interventional
154
1 country
2
Brief Summary
The goal of this clinical trial is to evaluate whether a dimensional adaptation of Good Psychiatric Management (called GPM-extended) is more effective than classic Good Psychiatric Management (GPM) in treating adult patients with borderline personality disorder (BPD). Briefly, the GPM-extended model integrates elements from existing adaptations of GPM for narcissistic and obsessive-compulsive personality disorders. It aims to provide a more personalized and dimensional approach to treatment, tailored to each patient's specific personality dysfunction and interpersonal triggers. The main questions it aims to answer are:
- Does GPM-extended improve overall BPD symptom severity more than classic GPM after one year of treatment?
- Does GPM-extended lead to better outcomes in related clinical domains (e.g., personality functioning, emotional regulation, social functioning...) ? Researchers will compare two groups:
- Patients treated in a center using the GPM-extended program.
- Patients treated in a center using the classic GPM program. In each group, patients will receive weekly outpatient psychiatric care for one year. In terms of evaluation, patients will be evaluated at baseline, 4 months, 8 months, and 1 year. They will undergo both clinician-administered and self-report assessments to measure BPD symptoms and other relevant psychological dimensions. This study hopes to contribute to the development of dimensional evidence-based treatments for personality disorders.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jun 2024
Longer than P75 for not_applicable
2 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
June 19, 2024
CompletedFirst Submitted
Initial submission to the registry
March 31, 2025
CompletedFirst Posted
Study publicly available on registry
April 6, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 1, 2029
ExpectedStudy Completion
Last participant's last visit for all outcomes
December 1, 2029
April 9, 2025
March 1, 2025
5.5 years
March 31, 2025
April 7, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Change in BPD symptom severity (ZAN-BPD total score)
Difference in mean change in total score on the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), a clinician-rated instrument assessing the severity of borderline symptoms. Scores range from 0 to 36, with higher scores indicating greater severity of borderline symptoms.
From baseline to 1 year.
Secondary Outcomes (21)
Change in BPD symptom dimensions (ZAN-BPD subscales)
From baseline to 1 year.
Change in personality functioning (LPFS-BF)
From baseline to 1 year.
Change in disability level (SDS)
From baseline to 1 year.
Change in social functioning (QFS)
From baseline to 1 year.
Change in suicidal and self-harming behaviors (SBBDM-S)
From baseline to 1 year.
- +16 more secondary outcomes
Study Arms (2)
GPM-Extended group (ADDIPSY, Lyon, France)
EXPERIMENTALParticipants receive a one-year outpatient treatment based on GPM-extended, a dimensional adaptation of Good Psychiatric Management for BPD. It includes weekly 1-hour individual therapy focused on dominant personality dilemmas (abandonment, self-esteem, control), guided by structured clinical and psychometric assessment. Psychiatric case management (30 min every 3 weeks) addresses medication and coordination of care. Group components include at least one 6-week psychoeducation program (borderline, narcissistic, or obsessive-compulsive focus) and, for high emotion dysregulation, an 18-week DBT skills training group.
Classic GPM (Clinique CARADOC, Bayonne, France)
ACTIVE COMPARATORParticipants receive a one-year outpatient treatment based on classic Good Psychiatric Management (GPM) for BPD. It includes weekly 1-hour individual therapy focused on interpersonal hypersensitivity, delivered by a GPM-trained therapist. Psychiatric case management (30 min every 3 weeks) addresses medication and coordination of care. Group interventions include a 6-week psychoeducation group on BPD and, for patients with high emotion dysregulation, an 18-week DBT skills training group.
Interventions
GPM-extended is a dimensional adaptation of Good Psychiatric Management (GPM) that retains its core principles-validation, real-life focus, alliance building-while enhancing flexibility and personalization. It emphasizes diagnostic clarity, treatment prioritization, and individualized psychoeducation based on three key personality dilemmas: fear of abandonment, self-esteem dysregulation, and control dependency. These dilemmas guide the focus of therapy and case management. Treatment goals are collaboratively set and regularly reassessed to align with the patient's evolving needs. The intervention includes weekly individual therapy and tailored group programs, with clinical strategies adapted to each dominant dilemma.
The classic GPM group follows the validated and manualized version of Good Psychiatric Management (GPM) for BPD. It emphasizes symptom stabilization through weekly individual therapy and pragmatic case management every 3 weeks. Unlike GPM-extended, it uses a uniform therapeutic framework rather than tailoring treatment to individual personality dilemmas,.The intervention includes weekly individual therapy and standardized group programs, with clinical strategies applied uniformly across patients, centered on interpersonal hypersensitivity and building stable life roles.
Eligibility Criteria
You may qualify if:
- Adults (≥18 years old)
- Diagnosis of borderline personality disorder according to the SCID-II (≥5 out of 9 criteria)
- Provision of written informed consent
- Affiliated with or beneficiary of the French national health insurance system
You may not qualify if:
- Age under 18 years
- Presence of a comorbid psychotic disorder, intellectual disability, severe antisocial traits, major substance use disorder incompatible with intensive therapy without abstinence, anorexia nervosa with somatic risk, or bipolar disorder in acute manic phase
- Individuals under legal protection (e.g., guardianship or legal safeguard)
- Individuals unable to cooperate or complete self- or clinician-administered questionnaires
- Individuals not affiliated with or not beneficiaries of the French national health insurance system
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- AddiPsylead
- Clinique Caradoccollaborator
Study Sites (2)
Clinique Caradoc
Bayonne, 64100, France
Addipsy
Lyon, 69007, France
Related Publications (10)
Ridolfi ME, Rossi R, Occhialini G, Gunderson JG. A Clinical Trial of a Psychoeducation Group Intervention for Patients With Borderline Personality Disorder. J Clin Psychiatry. 2019 Dec 31;81(1):19m12753. doi: 10.4088/JCP.19m12753.
PMID: 31917907BACKGROUNDMcMain SF, Guimond T, Streiner DL, Cardish RJ, Links PS. Dialectical behavior therapy compared with general psychiatric management for borderline personality disorder: clinical outcomes and functioning over a 2-year follow-up. Am J Psychiatry. 2012 Jun;169(6):650-61. doi: 10.1176/appi.ajp.2012.11091416.
PMID: 22581157BACKGROUNDMcMain SF, Links PS, Gnam WH, Guimond T, Cardish RJ, Korman L, Streiner DL. A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. Am J Psychiatry. 2009 Dec;166(12):1365-74. doi: 10.1176/appi.ajp.2009.09010039. Epub 2009 Sep 15.
PMID: 19755574BACKGROUNDBlay M, Benmakhlouf I, Duarte M, Perroud N, Greiner C, Charbon P, Choi-Kain L, Speranza M. Case reports: Using Good Psychiatric Management (GPM) conceptualizations in the dimensional assessment and treatment of personality disorders. Front Psychiatry. 2023 Jul 26;14:1186524. doi: 10.3389/fpsyt.2023.1186524. eCollection 2023.
PMID: 37564248BACKGROUNDWright AGC, Ringwald WR, Hopwood CJ, Pincus AL. It's time to replace the personality disorders with the interpersonal disorders. Am Psychol. 2022 Dec;77(9):1085-1099. doi: 10.1037/amp0001087.
PMID: 36595407BACKGROUNDWright AG, Hopwood CJ, Skodol AE, Morey LC. Longitudinal validation of general and specific structural features of personality pathology. J Abnorm Psychol. 2016 Nov;125(8):1120-1134. doi: 10.1037/abn0000165.
PMID: 27819472BACKGROUNDSharp C, Wright AG, Fowler JC, Frueh BC, Allen JG, Oldham J, Clark LA. The structure of personality pathology: Both general ('g') and specific ('s') factors? J Abnorm Psychol. 2015 May;124(2):387-98. doi: 10.1037/abn0000033. Epub 2015 Mar 2.
PMID: 25730515BACKGROUNDBach B, Kramer U, Doering S, di Giacomo E, Hutsebaut J, Kaera A, De Panfilis C, Schmahl C, Swales M, Taubner S, Renneberg B. The ICD-11 classification of personality disorders: a European perspective on challenges and opportunities. Borderline Personal Disord Emot Dysregul. 2022 Apr 1;9(1):12. doi: 10.1186/s40479-022-00182-0.
PMID: 35361271BACKGROUNDHopwood CJ, Kotov R, Krueger RF, Watson D, Widiger TA, Althoff RR, Ansell EB, Bach B, Michael Bagby R, Blais MA, Bornovalova MA, Chmielewski M, Cicero DC, Conway C, De Clercq B, De Fruyt F, Docherty AR, Eaton NR, Edens JF, Forbes MK, Forbush KT, Hengartner MP, Ivanova MY, Leising D, John Livesley W, Lukowitsky MR, Lynam DR, Markon KE, Miller JD, Morey LC, Mullins-Sweatt SN, Hans Ormel J, Patrick CJ, Pincus AL, Ruggero C, Samuel DB, Sellbom M, Slade T, Tackett JL, Thomas KM, Trull TJ, Vachon DD, Waldman ID, Waszczuk MA, Waugh MH, Wright AGC, Yalch MM, Zald DH, Zimmermann J. The time has come for dimensional personality disorder diagnosis. Personal Ment Health. 2018 Feb;12(1):82-86. doi: 10.1002/pmh.1408. Epub 2017 Dec 11. No abstract available.
PMID: 29226598BACKGROUNDGunderson JG, Herpertz SC, Skodol AE, Torgersen S, Zanarini MC. Borderline personality disorder. Nat Rev Dis Primers. 2018 May 24;4:18029. doi: 10.1038/nrdp.2018.29.
PMID: 29795363BACKGROUND
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Martin Blay, M.D., M.Sc
AddiPsy
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- NON RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
March 31, 2025
First Posted
April 6, 2025
Study Start
June 19, 2024
Primary Completion (Estimated)
December 1, 2029
Study Completion (Estimated)
December 1, 2029
Last Updated
April 9, 2025
Record last verified: 2025-03
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, ANALYTIC CODE
- Time Frame
- The protocol paper will be published before the end of 2026. Other IPD and related materials will be made publicly available starting from the first publication of study results, for an indefinite period, to support transparency and open science.
- Access Criteria
- Access to data will be provided via a dedicated OSF link published alongside each article.
De-identified individual participant data (IPD) used in published analyses will be shared through the Open Science Framework (OSF) platform for each resulting publication. This includes the datasets used in the statistical analyses and the corresponding statistical code. A separate protocol paper will be published prior to the main outcome publications. Data and code will be made available to promote transparency and open science, following the publication of each study output.