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Behav Res Ther. 2014 Sep;60:46-52. doi: 10.1016/j.brat.2014.07.001. Epub 2014 Jul 9.

Reasons for premature termination of dialectical behavior therapy for inpatients with borderline personality disorder.

Author information

1
Technical University Brunswick, Department of Psychology, Humboldtstraße 33, 38106 Brunswick, Germany. Electronic address: c.kroeger@tu-bs.de.
2
Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Benjamin Franklin Campus, Germany.
3
Criminological Research Institute of Lower Saxony, Lützerodestraße 9, 30161 Hannover, Germany.

Erratum in

  • Behav Res Ther. 2014 Dec;63:184. Röepke, Stefan [corrected to Roepke, Stefan].

Abstract

Although one of the main aims of dialectical behavior therapy (DBT) for borderline personality disorder (BPD) is to increase the retention rates, premature termination rates for DBT inpatient programs were found to be over 30%. The aim of the study was to identify the reasons for, and to analyze, patient characteristics that are associated with premature termination. We studied 541 inpatients with BPD, who were consecutively admitted for an open-door 3-month DBT inpatient treatment in Berlin, Germany. All participants completed several self-rating measures and participated in clinical interviews. Fourteen percent, who did not complete the full 84 days of assigned treatment, were expelled, mainly due to treatment-disturbing behaviors, or substance abuse or possession. Nearly 19% dropped out of treatment, mostly due to lack of motivation, arguments with others, and poor tolerance of emotional distress. Using non-parametric conditional inference trees, expulsion was associated with anorexia nervosa and alcohol abuse, whereas more than 9 suicide attempts, antisocial personality disorders, and more than 86 weeks in a psychiatric hospital were risk factors for dropout. We discussed measures and interventions that might lead to an adaptation of DBT inpatient programs. Future research should examine the symptom course and utilization of health-care services of non-completers.

KEYWORDS:

Borderline personality disorder; Comorbidity; Dialectical behavior therapy; Dropout; Inpatient treatment

PMID:
25058040
DOI:
10.1016/j.brat.2014.07.001
[Indexed for MEDLINE]
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