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Aust N Z J Psychiatry. 2009 May;43(5):397-408. doi: 10.1080/00048670902817711.

Early intervention for adolescents with borderline personality disorder: quasi-experimental comparison with treatment as usual.

Author information

1
ORYGEN Youth Health Research Centre, University of Melbourne, Locked Bag10, Parkville, Vic. 3052, Australia. achanen@unimelb.edu.au

Abstract

OBJECTIVE:

The aim of the present study was to compare the effectiveness of specialized team-based early intervention for borderline personality disorder (BPD) with treatment as usual.

METHOD:

In a quasi-experimental design, 32 outpatients who received historical treatment as usual (H-TAU) were compared with 78 participants from a recently published randomized controlled trial of cognitive analytic therapy (CAT; n = 41) versus manualized good clinical care (GCC; n = 37), conducted in a specialized early intervention service for BPD (the Helping Young People Early (HYPE) programme). All participants were 15-18-year-old outpatients who fulfilled 2-9 DSM-IV BPD criteria. It was predicted that, compared with H-TAU, HYPE + GCC and HYPE + CAT would show greater reductions in psychopathology and parasuicidal behaviour and greater improvement in global functioning over 24 months.

RESULTS:

At 24 month follow up: (i) HYPE + CAT had lower standardized levels of, and a significantly faster standardized rate of improvement in, internalizing and externalizing psychopathology, compared with H-TAU; and (ii) HYPE + GCC had lower standardized levels of internalizing psychopathology and a faster rate of improvement in global functioning than H-TAU. HYPE + CAT yielded the greatest median improvement on the four continuous outcome measures over 24 months. No adverse effects were shown with any of the treatments.

CONCLUSIONS:

Specialized early intervention for subsyndromal or full-syndrome BPD is more effective than TAU, with HYPE + CAT being the most effective intervention. Reform of existing services using the HYPE model might yield substantial improvements in patient outcomes.

PMID:
19373700
DOI:
10.1080/00048670902817711
[Indexed for MEDLINE]

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