Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: A pragmatic randomised controlled trial

Psychotherapy and Psychosomatics

Volumn 81, Issue 6, 2012, Pages 356-365

  Priebe, Stefan ^a,d   Bhatti, Nyla ^b   Barnicot, Kirsten ^a   Bremner, Stephen ^a   Gaglia, Amy ^b   Katsakou, Christina ^a,b   Molosankwe, Iris ^c   McCrone, Paul ^c   Zinkler, Martin ^a  

^a QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

^b EAST LONDON NHS FOUNDATION TRUST   (United Kingdom)

^c KING'S COLLEGE LONDON   (United Kingdom)

^d NEWHAM CENTRE FOR MENTAL HEALTH   (United Kingdom)

Author keywords

Borderline personality disorder; Cost effectiveness; Dialectical behaviour therapy; Self harm

Indexed keywords

ADULT; ARTICLE; AUTOMUTILATION; BEHAVIOR THERAPY; BORDERLINE STATE; BRIEF PSYCHIATRIC RATING SCALE; BRIEF SYMPTOM INVENTORY; CLIENT SERVICE RECEIPT INVENTORY; CONFIDENCE INTERVAL; CONTROLLED STUDY; COST EFFECTIVENESS ANALYSIS; DIALECTICAL BEHAVIOUR THERAPY; FEMALE; HARM REDUCTION; HEALTH CARE COST; HUMAN; INCIDENCE; INTENTION TO TREAT ANALYSIS; LANGUAGE; MAJOR CLINICAL STUDY; MALE; MANCHESTER SHORT ASSESSMENT OF QUALITY OF LIFE; MENTAL PATIENT; OUTCOME ASSESSMENT; PERSONALITY DISORDER; PRIORITY JOURNAL; PSYCHOLOGICAL RATING SCALE; QUALITY OF LIFE; RANDOMIZED CONTROLLED TRIAL; STATISTICAL SIGNIFICANCE; ZANARINI RATING SCALE FOR BORDERLINE PERSONALITY DISORDER;

ADULT; BEHAVIOR THERAPY; BORDERLINE PERSONALITY DISORDER; COST-BENEFIT ANALYSIS; COSTS AND COST ANALYSIS; FEMALE; HUMANS; MALE; PERSONALITY DISORDERS; SELF-INJURIOUS BEHAVIOR; TREATMENT OUTCOME;

EID: 84865835118     PISSN: 00333190     EISSN: 14230348     Source Type: Journal    
DOI: 10.1159/000338897     Document Type: Article

References (44)

1. Linehan MM: Cognitive-Behavioral Treat-ment of Borderline Personality Disorder. New York, Guildford Press, 1993.
2. Linehan MM: Skills Training Manual for Treating Borderline Personality Disorder. New York, Guildford Press, 1993.
3. Swenson CR, Torrey WC, Koerner K: Imple-menting dialectical behavior therapy. Psy-chiatr Serv 2002; 53: 171-178.
4. Feigenbaum J: Dialectical-behavior therapy: an increasing evidence base. J Ment Health 2007; 16: 51-68.
5. National Institute for Health and Clinical Excellence: Borderline Personality Disorder: Treatment and Management. London, Na-tional Institute for Health and Clinical Ex-cellence, 2009.
6. Linehan MM, Armstrong HE, Suarez A, All-mon D, Heard HL: Cognitive-behavioral treatment of chronically parasuicidal bor-derline patients. Arch Gen Psychiatry 1991; 48:1060-1064.
7. Linehan MM, Schmidt H, Dimeff LA, Craft JC, Kanter J, Comtois KA: Dialectical behav-ior therapy for patients with borderline per-sonality disorder and drug-dependence. Am J Addict 1999; 8: 279-292.
8. Koons CR, Robins CJ, Tweed JL, Lynch TR, Gonzalez AM, Morse JQ, Bishop GK, But-terfield MI, Bastian LA: Efficacy of dialecti-cal behavior therapy in women veterans with borderline personality disorder. Behav Ther 2001; 32:371-390. (Pubitemid 32995880)
9. Linehan MM, Dimeff LA, Reynolds SK, Comtois KA, Welch SS, Heagerty P, Kivlah-an DR: Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline per-sonality disorder. Drug Alcohol Depend 2002; 67: 13-26. (Pubitemid 34615925)
10. Verheul R, Van Den Bosch LMC, Koeter M WJ, Ridder M AJ, Stijnen T, Van Den Brink W: Dialectical behaviour therapy for women with borderline personality disorder. Br J Psychiatry 2003; 182: 135-140.
11. Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, Korslund KE, Tutek DA, Reynolds SK, Lindenboim N: Two-year randomised controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry 2006; 63: 757-767.
12. McMain SF, Links PS, Gnam WH, Guimond T, Cardish RJ, Korman L, Streiner DL: A ran-domized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. Am J Psy-chiatry 2009; 166:1365-1374.
13. Feigenbaum JD, Fonagy P, Pilling S, Jones A, Wildgoose A, Bebbington PE: A real-world study of the effectiveness of DBT in the UK National Health Service. Br J Clin Psychol 2012;51:121-141.
14. Kliem S, Kroger C, Kosfelder J: Dialectical behavior therapy for borderline personality disorder: a meta-analysis using mixed-ef-fects modelling. J Consult Clin Psychol 2010; 78:936-951.
15. Koerner K Dimeff LA: Further data on dia-lectical behavior therapy. Clin Psychol 2000; 7:104-112.
16. Meltzer H, Lader D, Corbin T, Singleton N, Jenkins R, Brugha T: Non-Fatal Suicidal Be-haviour among Adults Aged 16 to 74 in Great Britain. London, The Stationery Office, 2002.
17. Sinclair JM, Gray A, Rivero-Aria O, Saun-ders KE, Hawton K: Healthcare and social services resource use and costs of self-harm patients. Soc Psychiatry Psychiatr Epidemiol 2011; 46: 263-271.
18. Bender DS, Dolan RT, Skodol AE, Sanislow CA, Dyck IR, McGlashan TH, Shea MT, Zanarini MC, Oldham JM, Gunderson JG: Treatment utilization by patients with per-sonality disorders. Am J Psychiatry 2001; 158: 295-302. (Pubitemid 32116528)
19. Hörz S, Zanarini MC, Frankenburg FR, Reich DB, Fitzmaurice G: Ten-year use of mental health services by patients with bor-derline personality disorder and with other axis II disorders. Psychiatr Serv 2010; 61: 612-616.
20. Ansell EB, Sanislow CA, McGlashan TH, Grilo CM: Psychosocial impairment and treatment utilization by patients with bor-derline personality disorders, mood and anxiety disorders, and a healthy comparison group. Comp Psychiatry 2007; 48:329-336. (Pubitemid 46874360)
21. National Institute for Mental Health in En-gland: Personality Disorder: No Longer a Di-agnosis of Exclusion. London, National In-stitute for Mental Health in England, 2003.
22. Davidson KM, Tyrer P, Norrie J, Palmer SJ, Tyrer H: Cognitive therapy v usual treatment for borderline personality disorder: prospec-tive 6-year follow-up. Br J Psychiatry 2010; 197: 456-462.
23. Zinkler M, Gaglia A, Arokiadass SMR, Farhy E: Dialectical behaviour treatment: imple-mentation and outcomes. Psychiatr Bull 2007; 31:249-252. (Pubitemid 47045205)
24. First MB, Gibbon M, Spitzer RL, Williams JBW, Benjamin LS: Structured Clinical In-terview for DSM-IV Axis II Personality Dis-orders (SCID-II). Washington, American Psychiatric Press Inc, 1997.
25. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GCL: The Mini Interna-tional Neuropsychiatric Interview (MINI): the development and validation of a struc-tured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998; 59: 22-33. (Pubitemid 29001829)
26. Zanarini MC: Zanarini rating scale for bor-derline personality disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. J Pers Disord 2003; 17: 233- 242. (Pubitemid 36741563)
27. Ventura J, Green MF, Shaner A, Liberman RP: Training and quality assurance with the Brief Psychiatric Rating Scale: 'the drift bust-ers'. Int J Methods Psychiatr Res 1993; 3:221-224.
28. Derogatis LR: Brief Psychiatric Inventory Baltimore, Clinical Psychometric Research, 1975.
29. Burdock E, Fleiss JL, Hardesty AS: A new view of interobserver agreement. Pers Psy-chol 1963; 16: 373e84.
30. Priebe S, Huxley P, Knight S, Evans S: Appli-cation and results of the Manchester short assessment quality of life (M ANSA). Int J Soc Psychiatry 1999; 45:7-12. (Pubitemid 29158596)
31. Beecham J, Knapp M: Costing psychiatric interventions; in Thornicroft G (ed): Mea-suring Mental Health Needs, ed 2. London, Gaskell, 2001.
32. Cook TD, DeMets DL (eds): Introduction to Statistical Methods for Clinical Trials. Boca Raton, Taylor & Francis Group, 2008.
33. Curtis L: Unit Costs of Health and Social Care. Canterbury, PSSRU, 2010.
34. Jobe JB, White AA, Kelley CL: Recall strate-gies and memory of health care visits. Mil-bank Q 1990; 68:171-189.
35. Barnicot K, Katsakou C, Marougka S, Priebe S: Treatment completion in psychotherapy for borderline personality disorder - A sys-tematic review and meta-analysis. Acta Psy-chiatr Scand 2011; 123:327-338.
36. Bornalova MA, Daughters SB: How does dia-lectical behavior therapy facilitate treatment retention among individuals with comorbid borderline personality disorder and sub-stance use disorders? Clin Psychol Rev 2007; 27: 923-943. (Pubitemid 47600440)
37. Fertuck EA, Keilp J, Song I, Morris MC, Wil-son ST, Brodsky BS, Stanley B: Higher execu-tive control and visual memory performance predict treatment completion in borderline personality disorder. Psychother Psychosom 2012; 81: 38-43.
38. Clarkin JF, Levy KN, Lezenweger MF, Kern-berg OF: Evaluating three treatments for borderline personality disorder: a multiwave study. Am J Psychol 2007; 164:922-928. (Pubitemid 46972908)
39. Giesen-Bloo J, van Dyck R, Spinhoven P, van Tilburg W, Dirksen C, van Asselt T, Kremers I, Nadort M, Arntz A: Outpatient psycho-therapy for borderline personality disorder. Randomized trial of schema-focused thera-py vs transference-focused therapy. Psycho-ther Psychosom 2006; 63: 649-659.
40. Bos EH, van Wel EB, Appelo MT, Verbraak MJPM: Effectiveness of Systems Training for Emotional Predictability and Problem Solv-ing (STEPPS) for borderline personality problems in a 'real-world' sample: modera-tion by diagnosis or severity? Psychother Psychosom 2011; 80:173-181.
41. Bateman A, Fonagy P: Randomized con-trolled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality dis-order. Am J Psychiatry 2009; 166:1355-1364.
42. Pabst A, Schauer M, Bernhardt K, Ruf M, Goder R, Rosentraeger R, Elbert T, Alden-hoff J, Seeck-Hirschner M: Treatment of pa-tients with borderline personality disorder and comorbid posttraumatic stress disorder using narrative exposure therapy: a feasibil-ity study. Psychother Psychosom 2012; 81: 61-63.
43. Ogrodniczuk JS: New directions in treat-ment research for personality disorders: ef-fectiveness of different levels of care. Psycho-ther Psychosom 2011; 80:65-69.
44. Robins CJ, Chapman AL: Dialectical behav-ior therapy: current status, recent develop-ments, and future directions. J Pers Disord 2004; 18: 73-89. (Pubitemid 38338011)