Predictors of Clinical Course and Treatment Response in DBT Programmes
- Conditions
- Self HarmBorderline Personality Disorder
- Interventions
- Behavioral: Dialectical Behaviour Therapy adapted for adolescents (DBT-A)Behavioral: Dialectical Behaviour Therapy - Standard version (DBT)
- Registration Number
- NCT04318899
- Lead Sponsor
- Oslo University Hospital
- Brief Summary
The project is a collaboration between The National Centre for Suicide Research and Prevention (NSSF) and clinical units with Dialectical Behaviour Therapy (DBT) programmes. A methodological and technological platform has been established that enables clinicians to deliver high quality treatments over extended periods of time, to evaluate their own performance and productivity and to report it in a uniform and systematic way that will enable comparison across clinical settings and programmes. The collected data constitute the basis for conducting the clinical study with the overall aim to study predictors of the clinical course and treatment response in patients admitted to DBT programmes in Norway.
- Detailed Description
The aim of the project is to collect data from systematic and uniform clinical assessments to study predictors of the clinical course and treatment response in patients admitted to and treated in clinical units delivering Dialectical Behaviour Therapy in Norway.
Aims and research questions:
The study will address the following main research questions:
1. Which patient characteristics (sociodemographic variables, psychiatric diagnoses/comorbidities, previous suicidal and self-harming behaviour, previous treatment history), predict a favourable clinical course and treatment response?
2. Which factors mediate the clinical change in key outcomes such as a) target symptom levels (depression, hopelessness, suicidal ideation, borderline symptoms etc.), b) function levels (emotion regulation capacity, use of coping skills, social functioning, occupational / academic performance level etc.), c) problem behaviours (suicide attempts, non-suicidal self-harm, substance abuse, eating disorder symptoms etc.), d) global functioning and e) the use of emergency treatment services.
3. What are significant moderators of treatment response with respect to key clinical outcomes (mentioned above)?
4. Which of the treatment modalities are evaluated as the most salient and helpful by patients who receive the treatment according to their age, gender, psychiatric diagnoses and previous treatment history?
Methods:
A uniform protocol for psychiatric diagnostics and clinical assessment of patients who receive treatment at the participating clinical units will be used. Since some participating clinical units will treat adult patients and some will treat children and adolescents, the protocol will offer assessment instrument suitable for the specific age group whenever this is relevant. The evaluation system includes assessments at baseline before treatment starts, evaluation at several time points during the treatment period, at termination of treatment and at follow-up. Assessments will be made both through interviews and ratings made by therapists and through self-report from patients.
Self-reports will be filled out electronically by patients, on tablets stationed at each participating clinical unit. At intervals patients will also provide self-rated information on dimensions such as emotions, cognitions and impulsive behaviour several times per day through a mobile app developed specifically for the purpose, so-called Ecological Momentary Assessment (EMA). Interview data and ratings will be entered into the database by each clinician to tablets in a similar fashion as self-report data from patients.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 250
- History of repeated deliberate self harm
- Satisfies criteria of Diagnostic and Statistical Manual (DSM-IV) Borderline Personality Disorder as measured by Structured Clinical Interview for the DSM (SCID-II) in addition to the self-destructive criterion.
- Psychotic disorders
- Anorexia Nervosa
- Substance dependence disorder
- Mental retardation (IQ less than 70)
- Asperger syndrome/autism
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Dialectical Behaviour Therapy Dialectical Behaviour Therapy adapted for adolescents (DBT-A) Dialectical Behavior Therapy, delivered for 20 weeks for adolescents (DBT-A) or 52 weeks for adults (standard DBT. Dialectical Behaviour Therapy Dialectical Behaviour Therapy - Standard version (DBT) Dialectical Behavior Therapy, delivered for 20 weeks for adolescents (DBT-A) or 52 weeks for adults (standard DBT.
- Primary Outcome Measures
Name Time Method Suicidal Ideation (adults) 4 weeks Beck Scale for Suicidal Ideation (BSS). MIn=0, Max=38. Higher scores indicate worse outcome
Depressive symptoms (adolescents) 1 week Moods and Feelings Questionnaire (MFQ). Min=0, Max=26. Higher scores indicate worse outcome
Self-harm behaviour 4 weeks Number of self-harm episodes (split on suicide attempts and non-suicidal self-harm)
Suicidal Ideation (adolescents) 2 weeks Suicidal Ideation Questionnaire (SIQ-Jr). Min=0, Max=90. Higher scores indicate worse outcome
Depressive symptoms 1 week MADRS (Montgomery Asberg Depression Rating Scale).Min=0, Max=60. Higher scores indicate worse outcome
Depressive symptoms (adults) 1 week Beck Depression Inventory (BDI). Min=0, Max=63. Higher scores indicate worse outcome
- Secondary Outcome Measures
Name Time Method Borderline Symptoms 1 week Borderline Symptom List (BSL-23). Min=0, Max=92. Higher scores indicate more symptoms.
Hopelessness 1 week Beck Hopelessness Scale (BHS). Min=0, Max=20. Higher scores indicate more hopelessness.
Trial Locations
- Locations (5)
Moss DPS/Østfold sykehus HF
🇳🇴Moss, Norway
Bjerketun behandlingshjem/Vestreviken HF
🇳🇴Sandvika, Norway
BUP Lian/St Olavs Hospital HF
🇳🇴Trondheim, Norway
Søndre Oslo DPS/Oslo Universitetssykehus HF
🇳🇴Oslo, Norway
Psykiatrisk senter ytre Helgeland/Helgelandssykehuset HF
🇳🇴Sandnessjøen, Norway