Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Controlled Clinical Trial
. 2011 Jun 24:11:102.
doi: 10.1186/1471-244X-11-102.

Collaborative Care for patients with severe borderline and NOS personality disorders: a comparative multiple case study on processes and outcomes

Barbara Stringer  1 , Berno van Meijel, Bauke Koekkoek, Ad Kerkhof, Aartjan Beekman
Affiliations
Controlled Clinical Trial

Collaborative Care for patients with severe borderline and NOS personality disorders: a comparative multiple case study on processes and outcomes

Barbara Stringer et al. BMC Psychiatry. .

Abstract

Background: Structured psychotherapy is recommended as the preferred treatment of personality disorders. A substantial group of patients, however, has no access to these therapies or does not benefit. For those patients who have no (longer) access to psychotherapy a Collaborative Care Program (CCP) is developed. Collaborative Care originated in somatic health care to increase shared decision making and to enhance self management skills of chronic patients. Nurses have a prominent position in CCP's as they are responsible for optimal continuity and coordination of care. The aim of the CCP is to improve quality of life and self management skills, and reduce destructive behaviour and other manifestations of the personality disorder.

Methods/design: Quantitative and qualitative data are combined in a comparative multiple case study. This makes it possible to test the feasibility of the CCP, and also provides insight into the preliminary outcomes of CCP. Two treatment conditions will be compared, one in which the CCP is provided, the other in which Care as Usual is offered. In both conditions 16 patients will be included. The perspectives of patients, their informal carers and nurses are integrated in this study. Data (questionnaires, documents, and interviews) will be collected among these three groups of participants. The process of treatment and care within both research conditions is described with qualitative research methods. Additional quantitative data provide insight in the preliminary results of the CCP compared to CAU. With a stepped analysis plan the 'black box' of the application of the program will be revealed in order to understand which characteristics and influencing factors are indicative for positive or negative outcomes.

Discussion: The present study is, as to the best of our knowledge, the first to examine Collaborative Care for patients with severe personality disorders receiving outpatient mental health care. With the chosen design we want to examine how and which elements of the CC Program could contribute to a better quality of life for the patients.

Trial registration: Netherlands Trial Register (NTR): NTR2763.

PubMed Disclaimer

Figures

Figure 1
Figure 1
the five integrated components of the Collaborative Care program.
See this image and copyright information in PMC

References

    1. Weissman MM. The epidemiology of personality disorders: a 1990 update. J Pers Disord. 1993. pp. 44–62.
    1. Verheul R, Widiger TA. A meta-analysis of the prevalence and usage of the personality disorder not otherwise specified (PDNOS) diagnosis. J Pers Disord. 2004;18:309–319. - PubMed
    1. Bateman A, Fonagy P. 8-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment versus treatment as usual. Am J Psychiatry. 2008;165:631–638. doi: 10.1176/appi.ajp.2007.07040636. - DOI - PubMed
    1. Binks CA, Fenton M, McCarthy L, Lee T, Adams CE, Duggan C. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2006. p. CD005652. - PubMed
    1. Giesen-Bloo J, Dyck van R, Spinhoven P, Tilburg van W, Dirksen C, Asselt van T, Kremers I, Nadort M, Arntz A. Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy. Arch Gen Psychiatry. 2006;63:649–658. doi: 10.1001/archpsyc.63.6.649. - DOI - PubMed

Publication types

MeSH terms