Democratic therapeutic community treatment for personality disorder: Randomised controlled trial
Democratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent. To test whether DTC treatment reduces use of in-patient services and improves the mental heal...
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| Veröffentlicht in: | British journal of psychiatry 2017-02, Vol.210 (2), p.149-156 |
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| container_title | British journal of psychiatry |
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| creator | Pearce, Steve Scott, Lisle Attwood, Gillian Saunders, Kate Dean, Madeleine De Ridder, Ritz Galea, David Konstantinidou, Haroula Crawford, Mike |
| description | Democratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent.
To test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder.
An RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317). The intervention was DTC and the control condition was crisis planning plus treatment as usual (TAU). The primary outcome was days of in-patient psychiatric treatment. Secondary outcomes were social function, mental health status, self-harm and aggression, attendance at emergency departments and primary care, and satisfaction with care. All outcomes were measured at 12 and 24 months after randomisation.
Number of in-patient days at follow-up was low among all participants and there was no difference between groups. At 24 months, self- and other directed aggression and satisfaction with care were significantly improved in the DTC compared with the TAU group.
DTC is more effective than TAU in improving outcomes in personality disorder. Further studies are required to confirm this conclusion. |
| doi_str_mv | 10.1192/bjp.bp.116.184366 |
| format | Article |
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To test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder.
An RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317). The intervention was DTC and the control condition was crisis planning plus treatment as usual (TAU). The primary outcome was days of in-patient psychiatric treatment. Secondary outcomes were social function, mental health status, self-harm and aggression, attendance at emergency departments and primary care, and satisfaction with care. All outcomes were measured at 12 and 24 months after randomisation.
Number of in-patient days at follow-up was low among all participants and there was no difference between groups. At 24 months, self- and other directed aggression and satisfaction with care were significantly improved in the DTC compared with the TAU group.
DTC is more effective than TAU in improving outcomes in personality disorder. Further studies are required to confirm this conclusion.</description><identifier>ISSN: 0007-1250</identifier><identifier>EISSN: 1472-1465</identifier><identifier>DOI: 10.1192/bjp.bp.116.184366</identifier><identifier>PMID: 27908900</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adult ; Aggression ; Aggressiveness ; Alcohol ; Behavior modification ; Clinical outcomes ; Clinical trials ; Community mental health services ; Consent ; Decision making ; Emergency services ; Female ; Follow-Up Studies ; Health status ; Humans ; Inpatient care ; Intervention ; Length of Stay - statistics & numerical data ; Male ; Mental disorders ; Mental health care ; Mental health services ; Mental Health Services - statistics & numerical data ; Outcome Assessment (Health Care) ; Patient satisfaction ; Patients ; Personality ; Personality disorders ; Personality Disorders - therapy ; Primary care ; Psychiatry ; Psychosis ; Satisfaction ; Self destructive behavior ; Self injury ; Social function ; Substance abuse treatment ; Therapeutic Community</subject><ispartof>British journal of psychiatry, 2017-02, Vol.210 (2), p.149-156</ispartof><rights>Copyright © The Royal College of Psychiatrists 2017</rights><rights>The Royal College of Psychiatrists 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-7f9fbc04083e170ce91cf740f5376b3c943d2bed9f65a9f90349d3ad2245e5083</citedby><cites>FETCH-LOGICAL-c482t-7f9fbc04083e170ce91cf740f5376b3c943d2bed9f65a9f90349d3ad2245e5083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0007125000279725/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,776,780,12825,27321,27901,27902,30976,33751,55603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27908900$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pearce, Steve</creatorcontrib><creatorcontrib>Scott, Lisle</creatorcontrib><creatorcontrib>Attwood, Gillian</creatorcontrib><creatorcontrib>Saunders, Kate</creatorcontrib><creatorcontrib>Dean, Madeleine</creatorcontrib><creatorcontrib>De Ridder, Ritz</creatorcontrib><creatorcontrib>Galea, David</creatorcontrib><creatorcontrib>Konstantinidou, Haroula</creatorcontrib><creatorcontrib>Crawford, Mike</creatorcontrib><title>Democratic therapeutic community treatment for personality disorder: Randomised controlled trial</title><title>British journal of psychiatry</title><addtitle>Br J Psychiatry</addtitle><description>Democratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent.
To test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder.
An RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317). The intervention was DTC and the control condition was crisis planning plus treatment as usual (TAU). The primary outcome was days of in-patient psychiatric treatment. Secondary outcomes were social function, mental health status, self-harm and aggression, attendance at emergency departments and primary care, and satisfaction with care. All outcomes were measured at 12 and 24 months after randomisation.
Number of in-patient days at follow-up was low among all participants and there was no difference between groups. At 24 months, self- and other directed aggression and satisfaction with care were significantly improved in the DTC compared with the TAU group.
DTC is more effective than TAU in improving outcomes in personality disorder. Further studies are required to confirm this conclusion.</description><subject>Adult</subject><subject>Aggression</subject><subject>Aggressiveness</subject><subject>Alcohol</subject><subject>Behavior modification</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Community mental health services</subject><subject>Consent</subject><subject>Decision making</subject><subject>Emergency services</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health status</subject><subject>Humans</subject><subject>Inpatient care</subject><subject>Intervention</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Mental disorders</subject><subject>Mental health care</subject><subject>Mental health services</subject><subject>Mental Health Services - statistics & numerical data</subject><subject>Outcome Assessment (Health Care)</subject><subject>Patient satisfaction</subject><subject>Patients</subject><subject>Personality</subject><subject>Personality disorders</subject><subject>Personality Disorders - therapy</subject><subject>Primary care</subject><subject>Psychiatry</subject><subject>Psychosis</subject><subject>Satisfaction</subject><subject>Self destructive behavior</subject><subject>Self injury</subject><subject>Social function</subject><subject>Substance abuse treatment</subject><subject>Therapeutic Community</subject><issn>0007-1250</issn><issn>1472-1465</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>BHHNA</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkU9rFDEYxoMo7rb6AbyUAS9eZs3fSdKbrFoLCwXR85hJ3tRZZibTJHPot2-WXSsIxZ7yhPye503yIPSO4A0hmn7s9vOmm4tuNkRx1jQv0JpwSWvCG_ESrTHGsiZU4BU6S2lftoxT-RqtqNRYaYzX6NdnGIONJve2yr8hmhmWg7ZhHJepz_dVjmDyCFOufIjVDDGFyQyHE9enEB3Ey-q7mVwY-wSuGKccwzAUmWNvhjfolTdDgren9Rz9_Prlx_Zbvbu5ut5-2tWWK5pr6bXvLOZYMSASW9DEesmxF0w2HbOaM0c7cNo3wmivy0u0Y8ZRygWI4jpHH465cwx3C6TclvtYGAYzQVhSS7FWWinG9H9RojRRUjLBn4FyoajknBX0_T_oPiyxfFWZzYhoiNCcFIocKRtDShF8O8d-NPG-Jbg9lNqWUttuLrppj6UWz8UpeelGcI-OPy0WgJ1CzdjF3t3C39lPxz4AvHOvLA</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Pearce, Steve</creator><creator>Scott, Lisle</creator><creator>Attwood, Gillian</creator><creator>Saunders, Kate</creator><creator>Dean, Madeleine</creator><creator>De Ridder, Ritz</creator><creator>Galea, David</creator><creator>Konstantinidou, Haroula</creator><creator>Crawford, Mike</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7TK</scope><scope>7U3</scope><scope>7XB</scope><scope>88G</scope><scope>88J</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHHNA</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>M2M</scope><scope>M2O</scope><scope>M2R</scope><scope>M2S</scope><scope>MBDVC</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PKEHL</scope><scope>POGQB</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PRQQA</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>Democratic therapeutic community treatment for personality disorder: Randomised controlled trial</title><author>Pearce, Steve ; Scott, Lisle ; Attwood, Gillian ; Saunders, Kate ; Dean, Madeleine ; De Ridder, Ritz ; Galea, David ; Konstantinidou, Haroula ; Crawford, Mike</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-7f9fbc04083e170ce91cf740f5376b3c943d2bed9f65a9f90349d3ad2245e5083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aggression</topic><topic>Aggressiveness</topic><topic>Alcohol</topic><topic>Behavior modification</topic><topic>Clinical outcomes</topic><topic>Clinical trials</topic><topic>Community mental health services</topic><topic>Consent</topic><topic>Decision making</topic><topic>Emergency services</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health status</topic><topic>Humans</topic><topic>Inpatient care</topic><topic>Intervention</topic><topic>Length of Stay - 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Academic</collection><jtitle>British journal of psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pearce, Steve</au><au>Scott, Lisle</au><au>Attwood, Gillian</au><au>Saunders, Kate</au><au>Dean, Madeleine</au><au>De Ridder, Ritz</au><au>Galea, David</au><au>Konstantinidou, Haroula</au><au>Crawford, Mike</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Democratic therapeutic community treatment for personality disorder: Randomised controlled trial</atitle><jtitle>British journal of psychiatry</jtitle><addtitle>Br J Psychiatry</addtitle><date>2017-02</date><risdate>2017</risdate><volume>210</volume><issue>2</issue><spage>149</spage><epage>156</epage><pages>149-156</pages><issn>0007-1250</issn><eissn>1472-1465</eissn><abstract>Democratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent.
To test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder.
An RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317). The intervention was DTC and the control condition was crisis planning plus treatment as usual (TAU). The primary outcome was days of in-patient psychiatric treatment. Secondary outcomes were social function, mental health status, self-harm and aggression, attendance at emergency departments and primary care, and satisfaction with care. All outcomes were measured at 12 and 24 months after randomisation.
Number of in-patient days at follow-up was low among all participants and there was no difference between groups. At 24 months, self- and other directed aggression and satisfaction with care were significantly improved in the DTC compared with the TAU group.
DTC is more effective than TAU in improving outcomes in personality disorder. Further studies are required to confirm this conclusion.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>27908900</pmid><doi>10.1192/bjp.bp.116.184366</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of psychiatry, 2017-02, Vol.210 (2), p.149-156 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Cambridge Journals; Alma/SFX Local Collection; Sociological Abstracts |
| subjects | Adult Aggression Aggressiveness Alcohol Behavior modification Clinical outcomes Clinical trials Community mental health services Consent Decision making Emergency services Female Follow-Up Studies Health status Humans Inpatient care Intervention Length of Stay - statistics & numerical data Male Mental disorders Mental health care Mental health services Mental Health Services - statistics & numerical data Outcome Assessment (Health Care) Patient satisfaction Patients Personality Personality disorders Personality Disorders - therapy Primary care Psychiatry Psychosis Satisfaction Self destructive behavior Self injury Social function Substance abuse treatment Therapeutic Community |
| title | Democratic therapeutic community treatment for personality disorder: Randomised controlled trial |
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