Treatment Outcome of 18-Month, Day Hospital Mentalization-Based Treatment (MBT) in Patients with Severe Borderline Personality Disorder in the Netherlands

2012 ◽  
Vol 26 (4) ◽  
pp. 568-582 ◽  
Author(s):  
Dawn Bales ◽  
Nicole van Beek ◽  
Maaike Smits ◽  
Sten Willemsen ◽  
Jan J. V. Busschbach ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
The Netherlands ◽  
Borderline Personality ◽  
Day Hospital

scholarly journals Day hospital mentalization-based treatment v. specialist treatment as usual in patients with borderline personality disorder: randomized controlled trial

2018 ◽  
Vol 48 (15) ◽  
pp. 2522-2529 ◽  
Author(s):  
Elisabeth M. P. Laurenssen ◽  
Patrick Luyten ◽  
Martijn J. Kikkert ◽  
Dieuwertje Westra ◽  
Jaap Peen ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
The Netherlands ◽  
Borderline Personality ◽  
Outcome Variable ◽  
Day Hospital ◽  
Treatment As Usual ◽  
Specialist Treatment ◽  
Set Up

AbstractBackgroundDay hospital mentalization-based treatment (MBT-DH) is a promising treatment for borderline personality disorder (BPD) but its evidence base is still limited. This multi-site randomized trial compared the efficacy of MBT-DH delivered by a newly set-up service v. specialist treatment as usual (S-TAU) tailored to the individual needs of patients, and offered by a well-established treatment service.MethodsTwo mental healthcare institutes in The Netherlands participated in the study. Patients who met DSM-IV criteria for BPD and had a score of ⩾20 on the borderline personality disorder severity index (BPDSI) were randomly allocated to MBT-DH (N = 54) or S-TAU (N = 41). The primary outcome variable was the total score on the BPDSI. Secondary outcome variables included symptom severity, quality of life, and interpersonal functioning. Data were collected at baseline and every 6 months until 18-month follow-up, and were analyzed using multilevel analyses based on intention-to-treat principles.ResultsBoth treatments were associated with significant improvements in all outcome variables. MBT-DH was not superior to S-TAU on any outcome variable. MBT-DH was associated with higher acceptability in BPD patients compared v. S-TAU, reflected in significantly higher early drop-out rates in S-TAU (34%) v. MBT-DH (9%).ConclusionsMBT-DH delivered by a newly set-up service is as effective as specialist TAU in The Netherlands in the treatment of BPD at 18-month follow-up. Further research is needed to investigate treatment outcomes in the longer term and the cost-effectiveness of these treatments.

scholarly journals Day hospital versus intensive out-patient mentalisation-based treatment for borderline personality disorder: multicentre randomised clinical trial

2019 ◽  
Vol 216 (2) ◽  
pp. 79-84 ◽  
Author(s):  
Maaike L. Smits ◽  
Dine J. Feenstra ◽  
Hester V. Eeren ◽  
Dawn L. Bales ◽  
Elisabeth M. P. Laurenssen ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Outcome Measures ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Borderline Personality ◽  
Treatment Intensity ◽  
Day Hospital ◽  
Secondary Outcomes

BackgroundTwo types of mentalisation-based treatment (MBT) have been developed and empirically evaluated for borderline personality disorder (BPD): day hospital MBT (MBT-DH) and intensive out-patient MBT (MBT-IOP). No trial has yet compared their efficacy.AimsTo compare the efficacy of MBT-DH and MBT-IOP 18 months after start of treatment. MBT-DH was hypothesised to be superior to MBT-IOP because of its higher treatment intensity.MethodIn a multicentre randomised controlled trial (Nederlands Trial Register: NTR2292) conducted at three sites in the Netherlands, patients with BPD were randomly assigned to MBT-DH (n = 70) or MBT-IOP (n = 44). The primary outcome was symptom severity (Brief Symptom Inventory). Secondary outcome measures included borderline symptomatology, personality functioning, interpersonal functioning, quality of life and self-harm. Patients were assessed every 6 months from baseline to 18 months after start of treatment. Data were analysed using multilevel modelling based on intention-to-treat principles.ResultsSignificant improvements were found on all outcome measures, with moderate to very large effect sizes for both groups. MBT-DH was not superior to MBT-IOP on the primary outcome measure, but MBT-DH showed a clear tendency towards superiority on secondary outcomes.ConclusionsAlthough MBT-DH was not superior to MBT-IOP on the primary outcome measure despite its greater treatment intensity, MBT-DH showed a tendency to be more effective on secondary outcomes, particularly in terms of relational functioning. Patients receiving MBT-DH and MBT-IOP, thus, seem to follow different trajectories of change, which may have important implications for clinical decision-making. Longer-term follow-up and cost-effectiveness considerations may ultimately determine the optimal intensity of specialised treatments such as MBT for patients with BPD.

Barriers to Implementing the Clinical Guideline on Borderline Personality Disorder in the Netherlands

2011 ◽  
Vol 62 (11) ◽  
pp. 1381-1383 ◽  
Author(s):  
Marleen L. M. Hermens ◽  
Peter T. van Splunteren ◽  
Annemiek van den Bosch ◽  
Roel Verheul
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
The Netherlands ◽  
Clinical Guideline ◽  
Borderline Personality

Family Psychoeducation Approaches for Borderline Personality Disorder

2017 ◽  
Author(s):  
Valerie Porr
Keyword(s):  
Social Support ◽  
Treatment Outcome ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Family Members ◽  
Borderline Personality ◽  
Family Psychoeducation ◽  
Improve Treatment ◽  
Improve Treatment Outcome ◽  
The Family

This chapter provides a rationale for training family members of individuals with borderline personality disorder (BPD) to help them develop into therapeutic allies and treatment adjuncts. It also describes the experiences of family members in finding help for their loved ones with BPD and the family psychoeducation programs currently available for BPD and other disorders. By default, families often are the only alternative available to handle crisis situations since some individuals with BPD refuse to participate in therapy, have dropped out of therapy, or appropriate BPD services are not available in their communities. With an understanding of BPD, social support, and appropriate training, families can potentially develop as adjuncts and that can help improve treatment outcome

The cost of borderline personality disorder: societal cost of illness in BPD-patients

2007 ◽  
Vol 22 (6) ◽  
pp. 354-361 ◽  
Author(s):  
A.D.I. van Asselt ◽  
C.D. Dirksen ◽  
A. Arntz ◽  
J.L. Severens
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
The Netherlands ◽  
Cost Of Illness ◽  
Healthcare Costs ◽  
Structured Interview ◽  
Borderline Personality ◽  
Societal Cost ◽  
Outpatient Psychotherapy ◽  
Societal Costs

AbstractBackgroundBorderline personality disorder (BPD) is a highly prevalent, chronic condition. Because of its very problematic nature BPD is expected to be associated with substantial societal costs, although this has never been comprehensively assessed.ObjectiveEstimate the societal cost of BPD in the Netherlands.Study DesignWe used a prevalence-based bottom-up approach with a sample of 88 BPD patients who enrolled in a multicenter clinical trial comparing two kinds of outpatient psychotherapy. Costs were assessed by means of a structured interview, covering all healthcare costs, medication, informal care, productivity losses, and out-of-pocket expenses. Only BPD-related costs were included. All costs were expressed in Euros for the year 2000. A bootstrap procedure was performed to determine statistical uncertainty.PatientsAll patients had been diagnosed with BPD using DSM-IV criteria. Mean age was 30.5 years and 92% was female.ResultsBased on a prevalence of 1.1% and an adult population of 11,990,942, we derived that there were 131,900 BPD patients in the Netherlands. Total bootstrapped yearly cost of illness was €2,222,763,789 (€1,372,412,403–€3,260,248,300), only 22% was healthcare-related. Costs per patient were €16,852.ConclusionsAlthough healthcare costs of non-institutionalized Borderline patients might not be disproportionate, total societal costs are substantial.

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