BRIDGE项目:针对具有边缘型人格障碍特征的青少年(14 - 24岁)进行简短、密集评估和综合诊断的可行性随机对照试验(方案)

The BRIDGE project: a feasibility randomised controlled trial of brief, intensive assessment and integrated formulation for young people (age 14-24) with features of borderline personality disorder (Protocol).

作者信息

Gajwani Ruchika, Sim Fiona, McAllister Kirsty, Smith Helen, McIntosh Emma, Moran Paul, Ougrin Dennis, Smith Michael, Gumley Andrew Ian, Chanen Andrew M, Minnis Helen

机构信息

School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.

National Health Service Greater Glasgow and Clyde, Glasgow, United Kingdom.

出版信息

Front Psychiatry. 2024 Sep 24;15:1389578. doi: 10.3389/fpsyt.2024.1389578. eCollection 2024.

Abstract

BACKGROUND

Borderline personality disorder (BPD) is a severe mental disorder that is characterised by a pervasive pattern of instability of interpersonal relationships, self-image, and mood as well as marked impulsivity. BPD has its peak incidence and prevalence from puberty through to emerging adulthood. BPD is a controversial diagnosis in young people. Commonly, young people with BPD are under-diagnosed, untreated, are not in employment or training and are estranged from their families. Yet, they have complex needs and are at high suicide risk.

AIM

To assess the feasibility of conducting a randomised controlled trial (f-RCT) of a BRIDGE, a brief intervention programme for young people (age 14-24) with BPD symptoms (sub-threshold or threshold) in a community sample from Scotland, UK.

METHOD

Forty young people (age 14-24) meeting criteria for BPD symptoms, will be randomised in a 1:1 ratio to receive either a) the BRIDGE intervention plus service-as-usual or b) service-as-usual alone. Follow up will be 12 weeks and 24 weeks post-intervention. The study is carried out between 2021 to 2024.

OUTCOME

The two primary outcomes of the MQ funded, BRIDGE project (f-RCT) are i. recruitment rates and ii. retention rates. The study will present the acceptability and appropriateness of our putative outcome measures for a future definitive randomised controlled trial (d-RCT).

IMPACT

Young people with BPD benefit from good clinical care and targeted intervention, however are regularly missed or mislabelled. The community based feasibility trial would provide initial evidence of variable needs of young people with complex needs, who maybe missed or excluded from services as they don't "fit" a model/diagnosis. Workable multi-agency service model proposed in the trial would be a major advance in understanding care pathways regardless of trial outcome.

CLINICAL TRIAL REGISTRATION

ClinicalTrial.gov, identifier NCT05023447.

摘要

背景

边缘型人格障碍(BPD)是一种严重的精神障碍,其特征是人际关系、自我形象和情绪普遍不稳定,以及明显的冲动性。BPD在青春期到成年早期发病率和患病率最高。BPD在年轻人中是一个有争议的诊断。通常,患有BPD的年轻人诊断不足、未得到治疗、没有工作或接受培训,并且与家人疏远。然而,他们有复杂的需求,自杀风险很高。

目的

评估在英国苏格兰的社区样本中,对有BPD症状(亚阈值或阈值)的年轻人(14 - 24岁)开展BRIDGE(一个简短干预项目)随机对照试验(f - RCT)的可行性。

方法

40名符合BPD症状标准的14 - 24岁年轻人将按1:1比例随机分组,分别接受:a)BRIDGE干预加常规服务;b)仅常规服务。干预后12周和24周进行随访。该研究于2021年至2024年开展。

结果

由MQ资助的BRIDGE项目(f - RCT)的两个主要结果是:i. 招募率;ii. 留存率。该研究将展示我们假定的结果测量指标对于未来确定性随机对照试验(d - RCT)的可接受性和适用性。

影响

患有BPD的年轻人受益于良好的临床护理和针对性干预,但经常被漏诊或误诊。基于社区的可行性试验将为有复杂需求的年轻人的不同需求提供初步证据,这些年轻人可能因不符合某种模式/诊断而被服务遗漏或排除。试验中提出的可行的多机构服务模式,无论试验结果如何,都将是在理解护理途径方面的一大进步。

临床试验注册

ClinicalTrial.gov,标识符NCT05023447。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/849d/11458484/fde2c1069b07/fpsyt-15-1389578-g001.jpg

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