Joint crisis plans for people with borderline personalitydisorder: feasibility and outcomes in a randomised controlledtrial

BackgroundPeople with borderline personality disorder frequently experience crises.To date, no randomised controlled trials (RCTs) of crisis interventionsfor this population have been published.AimsTo examine the feasibility of recruiting and retaining adults withborderline personality disorder to a pilot RCT investigating thepotential efficacy and cost-effectiveness of using a joint crisisplan.MethodAn RCT of joint crisis plans for community-dwelling adults withborderline personality disorder (trial registration: ISRCTN12440268). Theprimary outcome measure was the occurrence of self-harming behaviour overthe 6-month period following randomisation. Secondary outcomes includeddepression, anxiety, engagement and satisfaction with services, qualityof life, well-being and cost-effectiveness.ResultsIn total, 88 adults out of the 133 referred were eligible and wererandomised to receive a joint crisis plan in addition to treatment asusual (TAU; n=46) or TAU alone (n=42).This represented approximately 75% of our target sample size andfollow-up data were collected on 73 (83.0%) participants.Intention-to-treat analysis revealed no significant differences in theproportion of participants who reported self-harming (odds ratio (OR)=1.9, 95% CI 0.53-6.5,P = 0.33) or the frequency ofself-harming behaviour (rate ratio (RR)=0.74, 95% CI 0.34-1.63,P=0.46) between the two groups at follow-up. Nosignificant differences were observed between the two groups on any ofthe secondary outcome measures or costs.ConclusionsIt is feasible to recruit and retain people with borderline personalitydisorder to a trial of joint crisis plans and the intervention appears tohave high face validity with this population. However, we found noevidence of clinical efficacy in this feasibility study.