Stolpegaard Psychotherapy Centre, Mental Health Services, Gentofte, Capital Region of Denmark, Denmark.
Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Trials. 2019 Apr 5;20(1):196. doi: 10.1186/s13063-019-3306-7.
Psychotherapy for borderline personality disorder is often lengthy and resource-intensive. However, the current length of outpatient treatments is arbitrary and based on trials that never tested if the treatment intensity could be reduced. As a result, there is insufficient evidence to inform the decision between short-term and long-term psychotherapy for borderline personality disorder. Mentalization-based therapy is one treatment option for borderline personality disorder and consists traditionally of an 18-month treatment program.
METHODS/DESIGN: This trial is an investigator-initiated single-center randomized clinical superiority trial of short-term (20 weeks) compared to long-term (14 months) mentalization-based therapy for outpatients with subthreshold or diagnosed borderline personality disorder. Participants will be recruited from the Outpatient Clinic for Personality Disorders at Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark. Participants will be included if they meet a minimum of four DSM-V criteria for borderline personality disorder. Participants will be assessed before randomization, and at 8, 16, and 24 months after randomization. The primary outcome is severity of borderline symptomatology assessed with the Zanarini Rating Scale for borderline personality disorder. Secondary outcomes include self-harm incidents, functional impairment (Work and Social Adjustment Scale, Global Assessment of Functioning) and quality of life (Short-Form Health Survey 36). Severity of psychiatric symptoms (Symptom Checklist 90-R) will be included as an exploratory outcome. Measures of personality functioning, attachment, borderline symptoms, group alliance, and mentalization skills will be included to explore potential predictors and mechanisms of change.
This trial will provide evidence of the beneficial and harmful effects of short-term compared to long-term mentalization-based therapy for outpatients with subthreshold or diagnosed borderline personality disorder.
ClinicalTrials.gov, NCT03677037 . Registered on September 19, 2018.
边缘型人格障碍的心理治疗通常耗时且资源密集。然而，目前的门诊治疗时长是任意的，并且基于从未测试过治疗强度是否可以降低的试验。因此，没有足够的证据来告知在边缘型人格障碍的短期和长期心理治疗之间做出选择。基于心理化的治疗是边缘型人格障碍的一种治疗选择，传统上包括一个 18 个月的治疗计划。
方法/设计：这是一项由研究者发起的、单中心、随机临床优效性试验，比较了短期（20 周）与长期（14 个月）基于心理化的治疗对边缘型人格障碍阈下或确诊门诊患者的疗效。参与者将从丹麦首都大区精神卫生服务 Stolpegaard 心理治疗中心的人格障碍门诊招募。如果参与者符合边缘型人格障碍的最低 DSM-V 标准的 4 项，则将其纳入研究。参与者将在随机分组前、随机分组后 8、16 和 24 个月进行评估。主要结局是使用边缘人格障碍评定量表评估的边缘症状严重程度。次要结局包括自伤事件、功能障碍（工作和社会适应量表、总体功能评估）和生活质量（简明健康调查问卷 36）。精神症状严重程度（症状清单 90-R）将作为探索性结局纳入。人格功能、依恋、边缘症状、团体联盟和心理化技能的测量将被纳入，以探索潜在的预测因素和变化机制。
该试验将提供关于短期与长期基于心理化的治疗对边缘型人格障碍阈下或确诊门诊患者的有益和有害影响的证据。
ClinicalTrials.gov，NCT03677037。于 2018 年 9 月 19 日注册。
