Purpose: The purpose of this study is to investigate the efficacy of Dialectical Behavior Therapy (DBT) versus CAMS (Collaborative Assessment and Management of Suicidality) -informed supportive psychotherapy on the risk of self-harm acts and suicide attempts in patients with self behavior and personality traits within the spectrum of borderline personality disorder. Hypothesis: The hypothesis is 16 weeks of treatment with Dialectical Behavior Therapy (DBT) after a defined manual has a higher efficacy than CAMS-informed supportive psychotherapy on self-harm acts, suicide attempts, suicidal ideation, depressive symptoms, impulsiveness and consumption of hospital services in patients with symptoms within the spectrum of borderline personality disorder (BDP). Method: The investigators will include 160 patients in the randomized trial to investigate whether 16 weeks of DBT-treatment as a higher efficacy than CAMS-informed supportive psychotherapy on the risk of self-harm acts and suicide attempts in patients with self-harm behavior and personality traits within the spectrum of borderline personality disorder. The trial will meet strict criteria for high quality randomized trials, and will hopefully help to establish evidence for the treatment of this patient group at higher risk of later suicide. There will be performed follow up interviews after 16 weeks, 28 weeks and 52 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
108
Mental Health Services, Research Unit, Bispebjerg
Copenhagen NV., Denmark
Number of repeated self-harming acts including suicide attempts (change in number of self-harming acts).
This information will be obtained as self-reported and through journal entries.How many acts how has taken place between the different time points in the trial (week 0, 17,28, and 52) to actually quantify the self-harming acts in order to find out if the treatment in the two arms can decrease the numbers of self-harming acts, also long term effect (week 52).
Time frame: Week 0 (baseline), 17, 28, 52.
Depressive symptoms
Measured by HDRS-17 and BDI.
Time frame: Assessed at baseline, after treatment period (16 weeks), Week 28 and 52 after inclusion
Impulsivity
Measured by Barratts Impulsivity Scale (BIS-11)
Time frame: Assessed at baseline, after treatment period (16 weeks), Week 28 and 52 after inclusion
Consumptions of services in hospital care.
Register based information: Contact with hospital contact with code 4 (self-harm act), or suicide attemp X60-X84, or poisioning by weak analgesia (T39), hypnotics (T52), or psychothopic drugs (T43). Vital status, causes of death, use of bed days and outpatients services.
Time frame: After treatment period (16 weeks), Week 28 and 52 after inclusion
Suicidal ideation
Measured by Beck's Suididal Ideation Scale (SSI-21)
Time frame: Assessed at baseline, after treatment period (16 weeks), Week 28 and 52 after inclusion
Severity of borderline personality disorder symptoms.
Measured by Zanarini Borderline Personality Scale.
Time frame: Assessed at baseline, after treatment period (16 weeks), Week 28 and 52 after inclusion
Anger
Measured by State Trait Anger Scale.
Time frame: Assessed at baseline, after treatment period (16 weeks), Week 28 and 52 after inclusion
Hopelessness
Measured by Becks Hopelessness Scale.
Time frame: Assessed at baseline, after treatment period (16 weeks), Week 28 and 52 after inclusion.
Self Esteem
Measured by Rosenbergs Self esteem Scale (RSE).
Time frame: Assessed at baseline, after treatment period (16 weeks), Week 28 and 52 after inclusion
Suicide related behavior.
Measured by Suicide Attempt Self Injury Interview (SASII) and Beck's suicide intent Scale
Time frame: Assessed at baseline, after treatment period (16 weeks), Week 28 and 52 after inclusion.
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