Is treatment in a day hospital step-down program superior to outpatient individual psychotherapy for patients with personality disorders? 36 months follow-up of a randomized clinical trial comparing different treatment modalities

Psychotherapy Research

Volumn 22, Issue 4, 2012, Pages 426-441

  Gullestad, Frida Slagstad ^a   Wilberg, Theresa ^a,b   Klungsøyr, Ole ^b   Johansen, Merete Selsbakk ^b   Urnes, Øyvind ^b   Karterud, Sigmund ^a,b  

^a UNIVERSITY OF OSLO   (Norway)

^b OSLO UNIVERSITY HOSPITAL   (Norway)

Author keywords

personality disorders; randomized clinical study; treatment modalities; treatment outcome

Indexed keywords

ADULT; AMBULATORY CARE; ARTICLE; CLINICAL TRIAL; COMPARATIVE STUDY; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DAY CARE; FEMALE; FOLLOW UP; GROUP THERAPY; HUMAN; MALE; METHODOLOGY; PERSONALITY DISORDER; PSYCHOTHERAPY; RANDOMIZED CONTROLLED TRIAL; TREATMENT OUTCOME;

ADULT; AMBULATORY CARE; DAY CARE; FEMALE; FOLLOW-UP STUDIES; HUMANS; MALE; PERSONALITY DISORDERS; PSYCHOTHERAPY; PSYCHOTHERAPY, GROUP; TREATMENT OUTCOME;

EID: 84864678625     PISSN: 10503307     EISSN: 14684381     Source Type: Journal    
DOI: 10.1080/10503307.2012.662608     Document Type: Article

References (52)

1. Alden, L.E., Wiggins, J.S. and Pincus, A.L. 1990. Construction of circumplex scales for the Inventory of Interpersonal Problems. Journal of Personality Assessment, 55: 521-526.
2. Arnevik, E., Wilberg, T., Urnes, O, Johansen, M., Monsen, J. and Karterud, S. 2009. Psychotherapy for personality disorders: Short term day hospital psychotherapy versus outpatient individual therapy-A randomized controlled study. European Psychiatry, 24: 71-78.
3. Arnevik, E., Wilberg, T., Urnes, O, Johansen, M., Monsen, J. and Karterud, S. 2010. Psychotherapy for personality disorders: 18 months' follow-up of the Ullevål Personality Project. Journal of Personality Disorders, 24: 188-203.
4. Bartak, A., Soeteman, D.I., Verheul, R. and Busschbach, J.J. 2007. Strengthening the status of psychotherapy for personality disorders: An integrated perspective on effects and costs. Canadian Journal of Psychiatry, 52: 803-810.
5. Bartak, A., Spreeuwenberg, M.D., Andrea, H., Holleman, L., Rijnierse, P., Rossum, B.V., Hamers, E.F.M., Meerman, A.M.M.A., Aerts, J., Busschbach, J.J.V., Verheul, R., Stijnen, T. and Emmelkamp, P.M.G. 2010. Effectiveness of different modalities of psychotherapeutic treatment for patients with cluster C personality disorders: results of a large prospective multicentre study. Psychotherapy and Psychosomatics, 79: 20-30.
6. Bartak, A., Andrea, H., Spreeuwenberg, M.D., Ziegler, U.M., Dekker, J., Rossum, B.V., Hamers, E.F.M., Scholte, W., Aerts, J., Busschbach, J.J.V., Verheul, R., Stijnen, T. and Emmelkamp, P.M.G. 2011a. Effectiveness of outpatient, day hospital, and inpatient psychotherapeutic treatment for patients with cluster B personality disorders. Psychotherapy and Psychosomatics, 80: 28-38.
7. Bartak, A., Andrea, H., Spreeuwenberg, M.D., Thunnissen, M., Ziegler, U.M., Dekker, J., Bouvy, F., Hamers, E.F.M., Meerman, A.M.M.A., Busschbach, J.J.V., Verheul, R., Stijnen, T. and Emmelkamp, P.M.G. 2011b. Patients with cluster A personality disorders in psychotherapy: an effectiveness study. Psychotherapy and Psychosomatics, 80: 88-99.
8. Bateman, A. and Fonagy, P. 1999. The effectiveness of partial hospitalization in the treatment of bordeline personality disorder-a randomised controlled trial. American Journal of Psychiatry, 156: 1563-1569.
9. Bateman, A. and Fonagy, P. 2001. Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: an 18-month follow-up. American Journal of Psychiatry, 158: 36-42.
10. Bateman, A. and Fonagy, P. 2008. 8-year follow-up of patients treated for borderline personality disorder: Mentalization-based treatment versus treatment as usual. American Journal of Psychiatry, 165: 631-638.
11. Bateman, A. and Fonagy, P. 2009. Randomized controlled trial of outpatient menatlization-based treatment versus structured clinical management for borderline personality disorder. American Journal of Psychiatry, 166: 1355-1364.
12. Beutler, L.E., Malik, M., Alimohamed, S., Harwood, T.M., Talebi, H., Noble, S. and Wong, E. 2004. "Therapist variables". In Bergin and Garfield's handbook of psychotherapy change, 5th ed, Edited by: Lambert, M.J. 227-307. New York: John Wiley & Sons.
13. Blum, N., St John, D., Pfohl, B., Stuart, S., McCormick, B.Allen, J. 2008. Systems training for emotional predictability and problem solving (STEPPS) for outpatients with borderline personality disorder: A randomized controlled trial and 1-year follow-up. American Journal of Psychiatry, 165: 468-478.
14. Chiesa, M., Fonagy, P., Holmes, J. and Drahorad, C. 2004. Residential versus community treatment of personality disorders: a comparative study of three treatment programs. American Journal of Psychiatry, 161: 1463-1470.
15. Clarkin, J.F., Levy, K.N., Lenzenweger, M.F. and Kernberg, O.F. 2007. Evaluating three treatments for borderline personality disorder: A multiwave study. American Journal of Psychiatry, 161: 922-928.
16. Derogatis, L.R. 1983. SCL-90-R manual: administration, scoring & procedures, USA: Clinical Psychometric Research.
17. Dinger, U., Strack, M., Leichsenring, F., Wilmers, F. and Schauenburg, H. 2008. Therapist effects on outcome and alliance in inpatient psychotherapy. Journal of Clinical Psychology, 64: 344-354.
18. Emmelkamp, P.M.G., Benner, A., Kuipers, A., Feiertag, G.A., Koster, H. and van Apeldoorn, F.J. 2006. Comparison of brief and cognitive-behavioural therapies in avoidant personality disorder. The British Journal of Psychiatry, 189: 60-64.
19. First, M.B., Gibbon, M., Spitzer, R.L., Williams, J.B. and Benjamin, L.S. 1997. Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID II), 1st ed, Washington, DC: American Psychiatric Press.
20. Fitzmaurice, G.M., Laird, N.M. and Ware, J.H. 2004. Applied Longitudinal Analysis, New Jersey: John Wiley & Sons.
21. Fixsen, D.L., Naoom, S.F., Blasé, K.A., Friedman, R.M. and Wallace, F. 2005. Implementation research: A synthesis of the literature, National Implementation Research Network.
22. Gabbard, G.O. 2008. Psychotherapies and lasting change (editorial). American Journal of Psychiatry, 165: 556-559.
23. Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C., van, Asselt, Kremers, I., Nadort, M. and Arntz, A. 2006. Outpatient psychotherapy for borderline personality disorder: Randomized trial of schema-focused psychotherapy. Archives of General Psychiatry, 63: 649-658.
24. Greenland, S. 2003. Quantifying biases in causal models: Classical confounding vs Collider-stratification bias. Epidemiology, 14: 300-306.
25. Groth-Marnat, G. 1990. The handbook of psychological assessment, 2nd ed, New York: John Wiley & Sons.
26. Herman, J.L., Perry, C. and van der Kolk, B.A. 1989. Childhood trauma in borderline personality disorder. American Journal of Psychiatry, 146: 490-495.
27. Hernan, M., Hernandez, S. and Robins, J. 2004. A structural approach to selection bias. Epidemiology, 15: 615-625.
28. Hummelen, B., Wilberg, T. and Karterud, S. 2007. Interviews of female patients with borderline personality disorder who dropped out of group psychotherapy. International Journal of Group Psychotherapy, 57: 67-91.
29. Jacobsen, N.S. and Truax, P. 1991. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59: 12-19.
30. Johnsen, J.G., Cohen, P., Brown, J., Smailes, E. and Bernstein, D.P. 1999. Childhood maltreatment increases risk for personality disorders during early adulthood. Archives of General Psychiatry, 56: 600-606.
31. Karterud, S., Johansen, M.S. and Wilberg, T. 2007. Conjoint group and individual psychotherapy in a research trial for patients with severe personality disorders. Group, 31: 31-46.
32. Karterud, S., Pedersen, G., Bjordal, E., Brabrand, J, Friis, S., Hasseth, O., Haavaldsen, G., Irion, T., Leirvåg, H., Tørum, E. and Urnes, Ø. 2003. Day treatment of patients with personality disorders: Experiences from a Norwegian treatment research network. Journal of Personality Disorder, 17: 243-262.
33. Karterud, S. and Wilberg, T. 2007. From general day hospital treatment to specialized treatment programmes. International Review of Psychiatry, 19, 2007: 39-49.
34. Krawitz, R. 1997. A prospective psychotherapy outcome study. Australian and New Zealand Journal of Psychiatry, 31: 456-473.
35. Linehan, M.M., Comtois, K.A., Murray, A.M., Brown, M.Z., Gallop, R.J., Heard, H.L., Korslund, K., Tutek, D.A., Reynolds, S. and Lindenboim, M.S. 2006. Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archieves of General Psychiatry, 63: 757-766.
36. Livesley, J. 2008. Integrated therapy for complex cases of personality disorders. Journal of Clinical Psychology, 64: 207-221.
37. Mundt, J.C., Isaac, M.M., Shear, K. and Greist, J.H. 2002. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. British Journal of Psychiatry, 180: 461-464.
38. Ogrodniczuk, J.S. 2011. New directions in treatment research for personality disorders: effectiveness of different levels of care. Psychotherapy and Psychosomatics, 80: 65-69.
39. Ogrodniczuk, J.S. and Piper, W.E. 2001. Day treatment for personality disorders: a review of research findings. Harvard Review of Psychiatry, 9: 105-117.
40. Pedersen, G. 2002. Circumplex of Interpersonal Problems (CIP): Norsk revidert versjon av Inventory of Interpersonal Problems- Circumplex (IIP-C). Journal of Norwegian Psychological Association, 39: 25-34.
41. Pedersen, G., Hagtvet, K.A. and Karterud, S. 2007. Generalizability studies of the Global Assessment of Functioning-Split version. Comprehensive Psychiatry, 48: 88-94.
42. Perry, J.C., Banon, E. and Ianni, F. 1999. Effectiveness of psychotherapy for personality disorders. American Journal of Psychiatry, 156: 1312-1321.
43. Piper, W.E., Rosie, J.S., Azim, H.F. and Joyce, A.S. 1993. A randomized trial of psychiatric day treatment for patients with affective and personality disorders. Hospital & Community Psychiatry, 44: 757-763.
44. R Development Core Team 2010. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing. 2010. ISBN 3-900051-07-0. http://www.R-project.org/.
45. Schauenburg, H., Buchheim, A.Beckh, K. 2010. The influence of psychodynamically oriented therapists' attachment representations on outcome and alliance in inpatient psychotherapy. Psychotherapy Research, 20: 193-202.
46. Shadish, W.R., Cook, T.D. and Campbell, D.T. 2002. Experimental and quasi-experimental designs for generalized causal inference, Boston: Houhton Mifflin.
47. Sheehan, D.V., Lecrubier, Y., Janavs, J., Knapp, E., Weiller, E., & Bonora, L.I. 1994 Mini International Neuropsychiatric Interview (M.I.N.I). Tampa University of South Florida College of Medicine.
48. Svartberg, M., Stiles, T.C. and Seltzer, M.H. 2004. Randomized controlled trial of the effectiveness of short-term dynamic psychotherapy and cognitive therapy for cluster C personality disorders. American Journal of Psychiatry, 161: 810-817.
49. Verheul, R. and Herbrink, M. 2007. The efficacy of various modalities of psychotherapy for personality disorders: a systematic review of the evidence and clinical recommendations. International Review of Psychiatry, 19: 25-38.
50. Wampold, B.E. 2001. The great psychotherapy debate. Models, methods and findings, London: Lawrence Erlbaum.
51. Wampold, B.E. and Brown, G. 2005. Estimating variability in outcomes attributable to therapists: A naturalistic study of outcomes in managed care. Journal of Consulting and Clinical Psychology, 73: 914-923.
52. Wilberg, T., Urnes, Ø, Friis, S., Irion, T., Pedersen, G. and Karterud, S. 1999. One-year follow-up of day treatment for poorly functioning patients with personality disorders. Psychiatric Services, 50: 1326-1330.