[Effectiveness of Dialectical Behavior Therapy (DBT) in an outpatient clinic for borderline personality disorders - impact of medication use and treatment costs]

Psychiatr Prax. 2014 Apr;41(3):148-52. doi: 10.1055/s-0033-1343204. Epub 2013 Jun 3.
[Article in German]

Abstract

Objective: Investigation of the clinical effectiveness of dialectical behavioral therapy in a day clinic setting (DBT-DC) for borderline personality disorders (BPD), and impact of medication and daily costs.

Methods: In a prospective, naturalistic, open and uncontrolled design BPD patients were enclosed in a 12-week DBT-DC. This DBT-program was certified by the German network of DBT. We collected data from the Symptom Checklist (SCL-90), the Beck Depression Inventory (BDI) and the Borderline Symptom List 95 (BSL-95) in the first and at the end of the 11th week. The concomitant medication and its changes were described.

Results: 31 cases were included (9 drop-outs: 29 %). The average age was 33.3 years (18 - 52, SD = 10.6). 21 females and one male completed the program. There was no relationship between changes of BDI, SCL-90 and BSL-95 scores (p < 0.001) and medication (and its alteration). The BDI scores improved by 50.8 % (p < 0.001), the SCL-90 by 42.9 % (p < 0.01) and the BSL-95 by 48.4 % (p < 0.001). The power was 0.99 (α = 0.05), the effect size was 1.41. In our setting the daily costs showed a reduction of about 6500 € per case compared to an inpatient DBT. Medications played no significant role for improvement.

Conclusions: For the first time a partial remission for BPD patients after 12 weeks has been shown to be achieved in a DBT-DC setting. DBT-DC reduces the primary costs of BPD compared to a specific inpatient therapy.

MeSH terms

  • Adolescent
  • Adult
  • Borderline Personality Disorder / diagnosis
  • Borderline Personality Disorder / economics*
  • Borderline Personality Disorder / psychology
  • Borderline Personality Disorder / therapy*
  • Cognitive Behavioral Therapy / economics*
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy / economics
  • Cost Savings / economics
  • Day Care, Medical / economics*
  • Day Care, Medical / methods*
  • Female
  • Germany
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • National Health Programs / economics*
  • Prospective Studies
  • Psychotropic Drugs / economics
  • Psychotropic Drugs / therapeutic use
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult

Substances

  • Psychotropic Drugs