PMID- 22103890
OWN - NLM
STAT- MEDLINE
DCOM- 20120406
LR  - 20220311
IS  - 1471-244X (Electronic)
IS  - 1471-244X (Linking)
VI  - 11
DP  - 2011 Nov 21
TI  - Supervised team management, with or without structured psychotherapy, in heavy 
      users of a mental health service with borderline personality disorder: a two-year 
      follow-up preliminary randomized study.
PG  - 181
LID - 10.1186/1471-244X-11-181 [doi]
AB  - BACKGROUND: Individuals affected by severe Borderline Personality Disorder (BPD) 
      are often heavy users of Mental Health Services (MHS). Short-term treatments 
      currently used in BPD therapy are useful to target disruptive behaviors but they 
      are less effective in reducing heavy MHS use. Therefore, alternative short-term 
      treatments, less complex than long-term psychodynamic psychotherapies but 
      specifically oriented to BPD core problems, need to be developed to reduce MHS 
      overuse. This study aimed to evaluate the efficacy of adding Sequential Brief 
      Adlerian Psychodynamic Psychotherapy (SB-APP) to Supervised Team Management (STM) 
      in BPD treatment compared to STM alone in a naturalistic group of heavy MHS users 
      with BPD. Effectiveness was evaluated 6 times along a two-year follow-up. 
      METHODS: Thirty-five outpatients who met inclusion criteria were randomly 
      assigned to two treatment groups (STM = 17; SB-APP = 18) and then compared. 
      Clinical Global Impression (CGI) and CGI-modified (CGI-M) for BPD, Global 
      Assessment of Functioning (GAF), State-Trait Anger Expression Inventory (STAXI), 
      and Symptom Checklist-90 Revised (SCL-90-R) were administered at T1, T3, T6, T12, 
      T18 and T24. At T12 the Working Alliance Inventory-Short Form (WAI-S) was also 
      completed. At the one-year follow-up, SB-APP group did not receive any additional 
      individual psychological support. MHS team was specifically trained in BPD 
      treatment and had regular supervisions. RESULTS: All patients improved on CGI, 
      GAF, and STAXI scores after 6 and 12 months, independently of treatment received. 
      SB-APP group showed better outcome on impulsivity, suicide attempts, chronic 
      feelings of emptiness, and disturbed relationships. We found a good stabilization 
      at the one year follow-up, even after the interruption of brief psychotherapy in 
      the SB-APP group. CONCLUSIONS: Although STM for BPD applied to heavy MHS users 
      was effective in reducing symptoms and improving their global functioning, adding 
      a time-limited and focused psychotherapy was found to achieve a better outcome. 
      In particular, focusing treatment on patients' personality with a specific 
      psychotherapeutic approach (i.e. SB-APP) seemed to be more effective than STM 
      alone. TRIAL REGISTRATION: ClinicalTrials.gov: NCT1356069.
FAU - Amianto, Federico
AU  - Amianto F
AD  - Neurosciences Department, Psychiatry Section, University of Torino, Turin, Italy.
FAU - Ferrero, Andrea
AU  - Ferrero A
FAU - Piero, Andrea
AU  - Piero A
FAU - Cairo, Elisabetta
AU  - Cairo E
FAU - Rocca, Giuseppe
AU  - Rocca G
FAU - Simonelli, Barbara
AU  - Simonelli B
FAU - Fassina, Simona
AU  - Fassina S
FAU - Abbate-Daga, Giovanni
AU  - Abbate-Daga G
FAU - Fassino, Secondo
AU  - Fassino S
LA  - eng
SI  - ClinicalTrials.gov/NCT01356069
SI  - ClinicalTrials.gov/NCT01356069
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20111121
PL  - England
TA  - BMC Psychiatry
JT  - BMC psychiatry
JID - 100968559
SB  - IM
MH  - Adult
MH  - Borderline Personality Disorder/psychology/*therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Mental Health
MH  - *Mental Health Services
MH  - Middle Aged
MH  - *Patient Care Team
MH  - Psychotherapy, Brief/*methods
MH  - Treatment Outcome
PMC - PMC3260092
EDAT- 2011/11/23 06:00
MHDA- 2012/04/07 06:00
PMCR- 2011/11/21
CRDT- 2011/11/23 06:00
PHST- 2011/05/10 00:00 [received]
PHST- 2011/11/21 00:00 [accepted]
PHST- 2011/11/23 06:00 [entrez]
PHST- 2011/11/23 06:00 [pubmed]
PHST- 2012/04/07 06:00 [medline]
PHST- 2011/11/21 00:00 [pmc-release]
AID - 1471-244X-11-181 [pii]
AID - 10.1186/1471-244X-11-181 [doi]
PST - epublish
SO  - BMC Psychiatry. 2011 Nov 21;11:181. doi: 10.1186/1471-244X-11-181.