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Comparing Mentalization-based Treatment And A Dialectical Behavior Therapy-inspired Treatment On The Utilization Of Services And The Dropout Rate In A Clinical Adult Population With A Cluster B Personality Disorder

Completed
Conditions
Borderline Personality Disorder
Cluster B Personality Disorder (Diagnosis)
Interventions
Behavioral: Mentalization-based Treatment
Behavioral: Dialectical Behavior Therapy-inspired Treatment
Registration Number
NCT05014217
Lead Sponsor
Ciusss de L'Est de l'Île de Montréal
Brief Summary

Cluster B personality disorders (borderline, narcissistic, antisocial and/or histrionic) are an important clinical consideration because of their high prevalence and associated morbidity. Although many studies examine borderline personality disorder, few of them explore cluster B personality disorders as a whole. In clinical practice, personality disorders are frequently comorbid. Patients who receive services in specialized clinics for these disorders often have a complex diagnosis that include many cluster B personality disorders. Therefore, our study globally examines patients with cluster B personality disorders even though borderline personality disorder is empirically the most studied psychopathology. Previous data suggests that borderline personality disorder has a prevalence of 2% in the general population, of 25% in the clinical psychiatric population and of 15% in all visits to the emergency room. Furthermore, it is associated with social costs estimated from 15,000$ to 50,000$ USD per patient per year. In Quebec, this psychopathology is associated with an increased mortality rate compared to the general population, totaling a loss of nine years for women and 13 years for men of life expectancy. Other studies suggest that borderline personality disorder is often comorbid with other personality disorders, including those in cluster B. The population with comorbid personality disorders have a worse prognosis and a lower chance of reaching symptomatic remission, which is the reason why it is crucial to better understand and study patients with cluster B personality disorders.

The study compares the effectiveness of two psychotherapies for borderline personality disorder, mentalization-based therapy and a modified version of Linehan's dialectical behavior therapy, in a retrospective naturalistic study of patients with at least one cluster B personality disorder who have undergone either treatment. The scarcity of data on cluster B personality disorders and on the comparison between MBT and DBT further highlights the necessity of a naturalistic study like ours to examine both aspects and bring research closer to the clinical setting. Based on clinical observations, the investigators believe that there will be no statistically significant difference between either treatment.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
403
Inclusion Criteria
  • Meet the general criteria for a personality disorder
  • Be diagnosed with at least one cluster B personality disorder
  • Be admitted to the Service of personality and relational disorders and referred to mentalization-based treatment or a treatment inspired from dialectical behavior therapy
Exclusion Criteria
  • None

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Mentalization-based TreatmentMentalization-based TreatmentParticipants who have been oriented to the mentalization-based treatment among the clinical adult population with a cluster B personality disorder.
Dialectical Behavior Therapy-inspired TreatmentDialectical Behavior Therapy-inspired TreatmentParticipants who have been oriented to the dialectical behavior therapy-inspired treatment among the clinical adult population with a cluster B personality disorder.
Primary Outcome Measures
NameTimeMethod
Number of HospitalizationsOne year before the index date (first group therapy meeting) to one year after the index date.

A comparison of the difference between a patient's number of hospitalizations in the year prior to and the year following the index date for each treatment.

Number of Visits To The Emergency RoomOne year before the index date (first group therapy meeting) to one year after the index date.

A comparison of the difference between a patient's number of visits to the emergency room in the year prior to and the year following the index date for each treatment.

Secondary Outcome Measures
NameTimeMethod
Dropout rateFrom the beginning until the end of the psychotherapy treatment.

The comparison of the dropout rate between mentalization-based treatment and dialectical behavior therapy.

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