Brief Psychological Intervention for Suicidal Patients with Borderline Personality Disorder in the Emergency Department

Not Applicable

Not yet recruiting

• Conditions: Borderline Personality Disorder (BPD)

• Registration Number: NCT06675461
• Lead Sponsor: Centre for Addiction and Mental Health

Brief Summary

When in crisis, people with borderline personality disorder (BPD) frequently seek care in emergency departments (EDs) often presenting with suicide and self-harm behaviour. There is no established evidence-based brief treatment for patients with BPD in ED settings, however a 4-session treatment for people with personality disorders in ED settings was tested in Australia and showed promising results in reducing health care use and improving symptoms. A recent pilot feasibility randomized controlled trial (RCT) comparing this 4-session treatment to treatment as usual was conducted at the Centre for Addiction and Mental Health and preliminary findings have shown that the treatment is feasible to deliver and acceptable to both patients and clinicians. The proposed fully powered RCT will build on this pilot data to assess the efficacy of delivering this 4-session intervention in the ED for people with BPD who present with suicidal ideation or self-harm with the aim of reducing emergency health care use and improving BPD symptoms, functioning and quality of life.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2024-11-04
• Study First Submitted QC: 2024-11-04
• Study First Posted: 2024-11-05
• Status Verified: 2024-12
• Study Start: 2024-12
• Last Update Submitted: 2024-12-02
• Last Update Posted: 2024-12-04
• Primary Completion: 2026-11
• Study Completion: 2026-11

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 180

Inclusion Criteria

1. Must be deemed to have capacity to provide informed consent;
2. Must sign and date the informed consent form;
3. Stated willingness to comply with all study procedures;
4. Aged 16 or older;
5. Presenting to ED with self-harm and/or suicidal ideation;
6. Meeting criteria for BPD on the International Personality Disorders Examination (IPDE).
7. Endorsing a score of 1 or greater on the Suicide Ideation Attributes Scale (SIDAS).

Exclusion Criteria

1. Meeting DSM-5 criteria for severe substance use disorder, schizophrenia spectrum disorder or bipolar disorder I mania based on the Structured Clinical Interview for DSM-5 (SCID-5);
2. IQ < 70 based on the Test of Premorbid Functioning (TOPF).

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Suicidal Ideation	6 Month Follow Up	Suicidal Ideation Attributes Scale (SIDAS): is a self-report questionnaire that assesses history and severity of suicidal behaviour and ideation. Scores range from 0-50 with lower scores indicating less suicidal ideation.

Secondary Outcome Measures

Name	Time	Method
Suicidal Ideation	3 Month Follow Up	Suicidal Ideation Attributes Scale (SIDAS): is a self-report questionnaire that assesses history and severity of suicidal behaviour and ideation. Scores range from 0-50 with lower scores indicating less suicidal ideation.
Health Care Use	3 and 6 Month Follow Up	Client Service Receipt Inventory (CSRI): is a brief self-report questionnaire assessing the frequency of patient contact with health, social care or other professionals, as well as emergency departments visits and hospital admissions.
Borderline Personality Disorder Symptoms	3 and 6 Month Follow Up	Borderline Symptom Checklist-23 (BSL-23): is a self report questionnaire that assesses BPD symptoms during the previous week. The 23-item questionnaire has patients rate their experience of symptoms on a 5-point scale from 0 (not at all) to 4 (very strong). Total score is an average with a minimum of 0 and a maximum of 4. Higher scores indicate more BPD symptoms.
Self-Harm Behavior	3 and 6 Month Follow Up	Deliberate Self-Harm Inventory (DSHI): is a 17-item self-report questionnaire measuring frequency, severity, duration, and type of self-harm, which is defined as the direct destruction of body tissue.
Emotion Regulation	3 and 6 Month Follow Up	Difficulties in Emotion Regulation Scale (DERS): ) is a self-report questionnaire that measures six facets of emotion regulation. Scores range from 0-180 with higher scores indicating more emotional dysregulation.
Depressive Symptoms	3 and 6 Month Follow Up	Patient Health Questionnaire-9 (PHQ-9): is a 9-item self-report questionnaire assessing depression severity. Scores range from 0-27 with higher scores indicating more severe depression.
Functioning	3 and 6 Month Follow Up	WHO Disability Assessment Schedule (WHODAS): is a self-report questionnaire measuring health and disability across all diseases, including mental, neurological and addictive disorders. It assesses functioning in cognition, mobility, self-care, getting along, life activities and participation. Total score can range from 0-100 with 100 indicating full disability.
Quality of Life	3 and 6 Month Follow Up	WHO Quality of Life (WHOQOL): is a brief self-report questionnaire assessing quality of life in domains of physical and psychological health, interpersonal relationships and environment. Scores range from 0-100 with 100 indicating the best possible state of health.