Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial
Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial
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DOI：
10.1192/bjp.bp.112.117762
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发表时间：
2013-05-01
影响因子：
10.5
通讯作者：
Moran, Paul
中科院分区：
文献类型：
--
作者：
Borschmann, Rohan;Barrett, Barbara;Moran, Paul
背景患有边缘性人格障碍的人经常经历危机。迄今为止，尚未发表针对该人群的危机干预措施的随机对照试验（RCT）。目的是检查招募和保留患有边缘性人格障碍的成年人参加试点随机对照试验的可行性，调查使用联合危机计划的潜在功效和成本效益。方法针对社区居住的患有边缘性人格障碍的成年人进行联合危机计划的随机对照试验（试验注册：ISRCTN12440268）。主要结果指标是随机分组后 6 个月内自残行为的发生情况。次要结局包括抑郁、焦虑、对服务的参与度和满意度、生活质量、幸福感和成本效益。结果总共，133 名转诊的成年人中有 88 名符合资格，并被随机分配接受除常规治疗外的联合危机计划 (TAU；n=46) 或单独 TAU (n=42)。这约占我们目标样本量的 75%，并且对 73 名 (83.0%) 参与者收集了后续数据。意向治疗分析显示，随访时两组报告自残的参与者比例（比值比（OR）=1.9，95% CI 0.53-6.5，P=0.33）或自残行为频率（比率（RR）=0.74，95% CI 0.34-1.63，P=0.46）没有显着差异。两组之间在任何次要结果指标或成本上均未观察到显着差异。结论招募并保留边缘型人格障碍患者参加联合危机计划试验是可行的，并且干预措施似乎对该人群具有很高的表面效度。然而，我们在这项可行性研究中没有发现临床疗效的证据。
BackgroundPeople with borderline personality disorder frequently experience crises. To date, no randomised controlled trials (RCTs) of crisis interventions for this population have been published.AimsTo examine the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot RCT investigating the potential efficacy and cost-effectiveness of using a joint crisis plan.MethodAn RCT of joint crisis plans for community-dwelling adults with borderline personality disorder (trial registration: ISRCTN12440268). The primary outcome measure was the occurrence of self-harming behaviour over the 6-month period following randomisation. Secondary outcomes included depression, anxiety, engagement and satisfaction with services, quality of life, well-being and cost-effectiveness.ResultsIn total, 88 adults out of the 133 referred were eligible and were randomised to receive a joint crisis plan in addition to treatment as usual (TAU; n=46) or TAU alone (n=42). This represented approximately 75% of our target sample size and follow-up data were collected on 73 (83.0%) participants. Intention-to-treat analysis revealed no significant differences in the proportion of participants who reported self-harming (odds ratio (OR)=1.9, 95% CI 0.53-6.5, P=0.33) Or the frequency of self-harming behaviour (rate ratio (RR)=0.74, 95% CI 0.34-1.63, P=0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures or costs.ConclusionsIt is feasible to recruit and retain people with borderline personality disorder to a trial of joint crisis plans and the intervention appears to have high face validity with this population. However, we found no evidence of clinical efficacy in this feasibility study.