Psychodynamic Therapy For Co-occurring Borderline Personality Disorder and Alcohol Use Disorder
|Borderline Personality Disorder Alcohol Use Disorder||Behavioral: Psychodynamic Therapy Behavioral: Optimized Community Care||Phase 2|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Psychodynamic Therapy for Patients With Borderline Personality Disorder and Alcohol Abuse|
- episodes of parasuicide, alcohol intoxication, institutional care [ Time Frame: 12 months ]
- depression, dissociation, core symptoms of borderline pd, perceived social support [ Time Frame: 12 months ]
|Study Start Date:||June 2004|
|Study Completion Date:||May 2010|
|Primary Completion Date:||May 2010 (Final data collection date for primary outcome measure)|
Experimental: dynamic deconstructive psychotherapy
weekly individual psychotherapy of 50 minute duration lasting 12-18 months
Behavioral: Psychodynamic Therapy
Dynamic deconstructive psychotherapy is a time-limited (12-18 month) manual-based form of psychodynamic therapy that aims to remediate specific neurocognitive capacities responsible for processing of emotional experiences.
Other Name: Dynamic Deconstructive Psychotherapy
Active Comparator: optimized community care
eclectic weekly individual and group psychotherapy, as well as drug and alcohol rehabilitation
Behavioral: Optimized Community Care
individual and group psychotherapy in a private practice, clinic, and/or rehab setting, with an eclectic orientation
Other Name: Treatment as Usual
Borderline Personality Disorder (BPD) is a condition that can cause significant distress and increased risk of death. Many persons with BPD also have an alcohol use disorder (AUD) and there is evidence that this can worsen the outcome and course of both disorders.
A manual-based form of psychodynamic therapy (PT), labeled dynamic deconstructive psychotherapy, has been developed for particularly challenging patients with BPD, especially those with co-occurring substance use disorders. It aims to remediate specific neurocognitive capacities that are responsible for processing of emotional experiences, and so diminishes symptoms of BPD and promotes the development of a coherent and differentiated self-structure. PT has been shown to be helpful for BPD, but has not been tested for people who have BPD with co-occurring substance use disorders.
The proposed study is a randomized controlled trial of PT for persons with BPD and co-occurring AUD that will generate some initial data that can be used to determine the need and feasibility for further outcome studies. Participants are randomized to either a study group receiving weekly PT or to a control group receiving usual care. Enrollment is 15 participants in each group. The study group will receive 12-18 months of PT, with naturalistic follow-up. Outcome measures are administered by a research assistant at enrollment, 3 months, 6 months, 9 months, 12 months, and 30 months.
The investigators anticipate that the PT group will show trends towards better retention in treatment and greater reduction in parasuicides, alcohol misuse, and institutional care. If so, this would have important and positive implications for the large group of patients who suffer from BPD and co-occurring AUD.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00145678
|United States, New York|
|SUNY Upstate Medical University, University Hospital|
|Syracuse, New York, United States, 13210|
|Principal Investigator:||Robert J. Gregory, M.D.||State University of New York - Upstate Medical University|