Mentalization‐based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial
Background Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence‐based psychotherapeutic programs, including mentalization‐based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD...
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| Veröffentlicht in: | Journal of child psychology and psychiatry 2020-05, Vol.61 (5), p.594-604 |
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| creator | Beck, Emma Bo, Sune Jørgensen, Mie Sedoc Gondan, Matthias Poulsen, Stig Storebø, Ole Jakob Fjellerad Andersen, Christian Folmo, Espen Sharp, Carla Pedersen, Jesper Simonsen, Erik |
| description | Background
Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence‐based psychotherapeutic programs, including mentalization‐based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT‐G) for adolescent BPD.
Method
A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms ≥4 DSM‐5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1‐year MBT‐G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS‐C); secondary outcomes included self‐harm, depression, externalizing and internalizing symptoms (all self‐report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326.
Results
At EOT, the primary outcome was 71.3 (SD = 15.0) in the MBT‐G group and 71.3 (SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS‐C units in favor of MBT‐G, 95% confidence interval −6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group.
Conclusions
There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed. |
| doi_str_mv | 10.1111/jcpp.13152 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2313376518</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2313376518</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3932-8c2829f38ca23b30a2224a5e28ce567c9c14c0bb8adc99b3836d43e85f5dd8ab3</originalsourceid><addsrcrecordid>eNp9kctKAzEUhoMotlY3PoAE3IgwNZeZacadFK9U7ELXQybJaEpmMiYzlBYEH8Fn9ElMW3XhwrM5i__jOxx-AA4xGuIwZzPRNENMcUK2QB_HaRaNUoy2QR8hgqMspagH9ryfIYRSmrBd0KN4hAhKWB-83au65UYveatt_fn-UXCvJGyd4m0VIqhr-Oxs13hYWge5tEZ5EQIP57p9gYV1UjmjawUb5bytg6tdQKn9OjiHHDpeS1vpZdAKW7fOGrO-oLnZBzslN14dfO8BeLq6fBzfRJOH69vxxSQSNKMkYoIwkpWUCU5oQREnhMQ8UYQJlaQjkQkcC1QUjEuRZQVlNJUxVSwpEykZL-gAnGy8jbOvnfJtXunwhTG8VrbzOaGY0lGaYBbQ4z_ozHYuvLWiMozSeMUOwOmGEs5671SZN05X3C1yjPJVKfmqlHxdSoCPvpVdUSn5i_60EAC8AebaqMU_qvxuPJ1upF_EGpqs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2391064313</pqid></control><display><type>article</type><title>Mentalization‐based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Wiley Online Library All Journals</source><creator>Beck, Emma ; Bo, Sune ; Jørgensen, Mie Sedoc ; Gondan, Matthias ; Poulsen, Stig ; Storebø, Ole Jakob ; Fjellerad Andersen, Christian ; Folmo, Espen ; Sharp, Carla ; Pedersen, Jesper ; Simonsen, Erik</creator><creatorcontrib>Beck, Emma ; Bo, Sune ; Jørgensen, Mie Sedoc ; Gondan, Matthias ; Poulsen, Stig ; Storebø, Ole Jakob ; Fjellerad Andersen, Christian ; Folmo, Espen ; Sharp, Carla ; Pedersen, Jesper ; Simonsen, Erik</creatorcontrib><description>Background
Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence‐based psychotherapeutic programs, including mentalization‐based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT‐G) for adolescent BPD.
Method
A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms ≥4 DSM‐5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1‐year MBT‐G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS‐C); secondary outcomes included self‐harm, depression, externalizing and internalizing symptoms (all self‐report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326.
Results
At EOT, the primary outcome was 71.3 (SD = 15.0) in the MBT‐G group and 71.3 (SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS‐C units in favor of MBT‐G, 95% confidence interval −6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group.
Conclusions
There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed.</description><identifier>ISSN: 0021-9630</identifier><identifier>EISSN: 1469-7610</identifier><identifier>DOI: 10.1111/jcpp.13152</identifier><identifier>PMID: 31702058</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>adolescence ; Adolescents ; Borderline personality disorder ; Caregivers ; Case formulation ; Child & adolescent psychiatry ; Clinical trials ; Control Groups ; Disability ; Early intervention ; Efficacy ; group psychotherapy ; Internalization ; Mentalization‐based treatment ; mentalizing ; Outpatient clinics ; Personality disorders ; Personality Problems ; Psychotherapy ; Remission (Medicine) ; Social functioning ; Teenagers</subject><ispartof>Journal of child psychology and psychiatry, 2020-05, Vol.61 (5), p.594-604</ispartof><rights>2019 Association for Child and Adolescent Mental Health</rights><rights>2019 Association for Child and Adolescent Mental Health.</rights><rights>Copyright © 2020 Association for Child and Adolescent Mental Health</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3932-8c2829f38ca23b30a2224a5e28ce567c9c14c0bb8adc99b3836d43e85f5dd8ab3</citedby><cites>FETCH-LOGICAL-c3932-8c2829f38ca23b30a2224a5e28ce567c9c14c0bb8adc99b3836d43e85f5dd8ab3</cites><orcidid>0000-0003-3398-9452</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjcpp.13152$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjcpp.13152$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,30999,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31702058$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beck, Emma</creatorcontrib><creatorcontrib>Bo, Sune</creatorcontrib><creatorcontrib>Jørgensen, Mie Sedoc</creatorcontrib><creatorcontrib>Gondan, Matthias</creatorcontrib><creatorcontrib>Poulsen, Stig</creatorcontrib><creatorcontrib>Storebø, Ole Jakob</creatorcontrib><creatorcontrib>Fjellerad Andersen, Christian</creatorcontrib><creatorcontrib>Folmo, Espen</creatorcontrib><creatorcontrib>Sharp, Carla</creatorcontrib><creatorcontrib>Pedersen, Jesper</creatorcontrib><creatorcontrib>Simonsen, Erik</creatorcontrib><title>Mentalization‐based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial</title><title>Journal of child psychology and psychiatry</title><addtitle>J Child Psychol Psychiatry</addtitle><description>Background
Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence‐based psychotherapeutic programs, including mentalization‐based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT‐G) for adolescent BPD.
Method
A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms ≥4 DSM‐5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1‐year MBT‐G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS‐C); secondary outcomes included self‐harm, depression, externalizing and internalizing symptoms (all self‐report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326.
Results
At EOT, the primary outcome was 71.3 (SD = 15.0) in the MBT‐G group and 71.3 (SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS‐C units in favor of MBT‐G, 95% confidence interval −6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group.
Conclusions
There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed.</description><subject>adolescence</subject><subject>Adolescents</subject><subject>Borderline personality disorder</subject><subject>Caregivers</subject><subject>Case formulation</subject><subject>Child & adolescent psychiatry</subject><subject>Clinical trials</subject><subject>Control Groups</subject><subject>Disability</subject><subject>Early intervention</subject><subject>Efficacy</subject><subject>group psychotherapy</subject><subject>Internalization</subject><subject>Mentalization‐based treatment</subject><subject>mentalizing</subject><subject>Outpatient clinics</subject><subject>Personality disorders</subject><subject>Personality Problems</subject><subject>Psychotherapy</subject><subject>Remission (Medicine)</subject><subject>Social functioning</subject><subject>Teenagers</subject><issn>0021-9630</issn><issn>1469-7610</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNp9kctKAzEUhoMotlY3PoAE3IgwNZeZacadFK9U7ELXQybJaEpmMiYzlBYEH8Fn9ElMW3XhwrM5i__jOxx-AA4xGuIwZzPRNENMcUK2QB_HaRaNUoy2QR8hgqMspagH9ryfIYRSmrBd0KN4hAhKWB-83au65UYveatt_fn-UXCvJGyd4m0VIqhr-Oxs13hYWge5tEZ5EQIP57p9gYV1UjmjawUb5bytg6tdQKn9OjiHHDpeS1vpZdAKW7fOGrO-oLnZBzslN14dfO8BeLq6fBzfRJOH69vxxSQSNKMkYoIwkpWUCU5oQREnhMQ8UYQJlaQjkQkcC1QUjEuRZQVlNJUxVSwpEykZL-gAnGy8jbOvnfJtXunwhTG8VrbzOaGY0lGaYBbQ4z_ozHYuvLWiMozSeMUOwOmGEs5671SZN05X3C1yjPJVKfmqlHxdSoCPvpVdUSn5i_60EAC8AebaqMU_qvxuPJ1upF_EGpqs</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Beck, Emma</creator><creator>Bo, Sune</creator><creator>Jørgensen, Mie Sedoc</creator><creator>Gondan, Matthias</creator><creator>Poulsen, Stig</creator><creator>Storebø, Ole Jakob</creator><creator>Fjellerad Andersen, Christian</creator><creator>Folmo, Espen</creator><creator>Sharp, Carla</creator><creator>Pedersen, Jesper</creator><creator>Simonsen, Erik</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3398-9452</orcidid></search><sort><creationdate>202005</creationdate><title>Mentalization‐based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial</title><author>Beck, Emma ; Bo, Sune ; Jørgensen, Mie Sedoc ; Gondan, Matthias ; Poulsen, Stig ; Storebø, Ole Jakob ; Fjellerad Andersen, Christian ; Folmo, Espen ; Sharp, Carla ; Pedersen, Jesper ; Simonsen, Erik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3932-8c2829f38ca23b30a2224a5e28ce567c9c14c0bb8adc99b3836d43e85f5dd8ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>adolescence</topic><topic>Adolescents</topic><topic>Borderline personality disorder</topic><topic>Caregivers</topic><topic>Case formulation</topic><topic>Child & adolescent psychiatry</topic><topic>Clinical trials</topic><topic>Control Groups</topic><topic>Disability</topic><topic>Early intervention</topic><topic>Efficacy</topic><topic>group psychotherapy</topic><topic>Internalization</topic><topic>Mentalization‐based treatment</topic><topic>mentalizing</topic><topic>Outpatient clinics</topic><topic>Personality disorders</topic><topic>Personality Problems</topic><topic>Psychotherapy</topic><topic>Remission (Medicine)</topic><topic>Social functioning</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beck, Emma</creatorcontrib><creatorcontrib>Bo, Sune</creatorcontrib><creatorcontrib>Jørgensen, Mie Sedoc</creatorcontrib><creatorcontrib>Gondan, Matthias</creatorcontrib><creatorcontrib>Poulsen, Stig</creatorcontrib><creatorcontrib>Storebø, Ole Jakob</creatorcontrib><creatorcontrib>Fjellerad Andersen, Christian</creatorcontrib><creatorcontrib>Folmo, Espen</creatorcontrib><creatorcontrib>Sharp, Carla</creatorcontrib><creatorcontrib>Pedersen, Jesper</creatorcontrib><creatorcontrib>Simonsen, Erik</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of child psychology and psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beck, Emma</au><au>Bo, Sune</au><au>Jørgensen, Mie Sedoc</au><au>Gondan, Matthias</au><au>Poulsen, Stig</au><au>Storebø, Ole Jakob</au><au>Fjellerad Andersen, Christian</au><au>Folmo, Espen</au><au>Sharp, Carla</au><au>Pedersen, Jesper</au><au>Simonsen, Erik</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mentalization‐based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial</atitle><jtitle>Journal of child psychology and psychiatry</jtitle><addtitle>J Child Psychol Psychiatry</addtitle><date>2020-05</date><risdate>2020</risdate><volume>61</volume><issue>5</issue><spage>594</spage><epage>604</epage><pages>594-604</pages><issn>0021-9630</issn><eissn>1469-7610</eissn><abstract>Background
Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence‐based psychotherapeutic programs, including mentalization‐based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT‐G) for adolescent BPD.
Method
A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms ≥4 DSM‐5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1‐year MBT‐G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS‐C); secondary outcomes included self‐harm, depression, externalizing and internalizing symptoms (all self‐report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326.
Results
At EOT, the primary outcome was 71.3 (SD = 15.0) in the MBT‐G group and 71.3 (SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS‐C units in favor of MBT‐G, 95% confidence interval −6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group.
Conclusions
There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>31702058</pmid><doi>10.1111/jcpp.13152</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-3398-9452</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Wiley Online Library All Journals |
| subjects | adolescence Adolescents Borderline personality disorder Caregivers Case formulation Child & adolescent psychiatry Clinical trials Control Groups Disability Early intervention Efficacy group psychotherapy Internalization Mentalization‐based treatment mentalizing Outpatient clinics Personality disorders Personality Problems Psychotherapy Remission (Medicine) Social functioning Teenagers |
| title | Mentalization‐based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial |
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