Effectiveness and safety of the adjunctive use of an internet-based self-management intervention for borderline personality disorder in addition to care as usual: results from a randomised controlled trial.

Klein, Jan Philipp; Hauer-von Mauschwitz, Andrea; Fassbinder, Eva; Berger, Thomas; Mayer, Johannes; Borgwardt, Stefan; Wellhöfer, Bernhard; Schweiger, Ulrich; Jacob, Gitta (2021). Effectiveness and safety of the adjunctive use of an internet-based self-management intervention for borderline personality disorder in addition to care as usual: results from a randomised controlled trial. BMJ open, 11(9), e047771. BMJ Publishing Group 10.1136/bmjopen-2020-047771

[img]
Preview
Text
e047771.full.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (477kB) | Preview

IMPORTANCE: Borderline personality disorder (BPD) is a severe mental disorder that is often inadequately treated.

OBJECTIVE: To determine if adding a self-management intervention to care as usual (CAU) is effective and safe.

DESIGN: Randomised, controlled, rater-blind trial. Duration of treatment and assessments: 12 months.

SETTING: Secondary care, recruited mainly via the internet.

PARTICIPANTS: Patients with BPD and BPD Severity Index (BPDSI) of at least 15.

INTERVENTIONS: CAU by treating psychiatrist and/or psychotherapist alone or adjunctive use of an internet-based self-management intervention that is based on schema therapy (priovi).

MAIN OUTCOME MEASURE: Outcomes were assessed by trained raters. The primary outcome was change in BPDSI. The safety outcome was the number of serious adverse events (SAEs). The primary outcome time point was 12 months after randomisation.

RESULTS: Of 383 participants assessed for eligibility, 204 were included (91.7% female, mean age: 32.4 years; 74% were in psychotherapy and 26% were in psychiatric treatment). The slope of BPDSI change did not differ significantly between groups from baseline to 12 months (F3,248= 1.857, p=0.14). At 12 months, the within-group effect sizes were d=1.38 (95% CI 1.07 to 1.68) for the intervention group and d=1.02 (95% CI 0.73 to 1.31) for the control group. The between-group effect size was d=0.27 (95% CI 0.00 to 0.55) in the intention-to-treat sample and d=0.39 (95% CI 0.09 to 0.68) for those who used the intervention for at least 3 hours (per-protocol sample). We found no significant differences in SAEs.

CONCLUSIONS: We have not found a significant effect in favour of the intervention. This might be due to the unexpectedly large effect in the group receiving CAU by a psychiatrist and/or psychotherapist alone.

Item Type:

Journal Article (Original Article)

Division/Institute:

07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy

UniBE Contributor:

Berger, Thomas (B)

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2044-6055

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Melanie Best

Date Deposited:

13 Jan 2022 12:08

Last Modified:

29 Mar 2023 23:38

Publisher DOI:

10.1136/bmjopen-2020-047771

PubMed ID:

34497078

Uncontrolled Keywords:

adult psychiatry clinical trials personality disorders suicide & self-harm

BORIS DOI:

10.48350/162384

URI:

https://boris.unibe.ch/id/eprint/162384

Actions (login required)

Edit item Edit item
Provide Feedback