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Randomized Controlled Trial
. 2018 Oct 19;18(1):341.
doi: 10.1186/s12888-018-1905-6.

PRO*BPD: effectiveness of outpatient treatment programs for borderline personality disorder: a comparison of Schema therapy and dialectical behavior therapy: study protocol for a randomized trial

Eva Fassbinder  1 , Nele Assmann  2 , Anja Schaich  2 , Kristin Heinecke  2 , Till Wagner  2 , Valerija Sipos  2 , Kamila Jauch-Chara  2 , Michael Hüppe  3 , Arnoud Arntz  4 , Ulrich Schweiger  2
Affiliations
Randomized Controlled Trial

PRO*BPD: effectiveness of outpatient treatment programs for borderline personality disorder: a comparison of Schema therapy and dialectical behavior therapy: study protocol for a randomized trial

Eva Fassbinder et al. BMC Psychiatry. .

Abstract

Background: Borderline Personality Disorder (BPD) is a severe mental illness that is associated with low quality of life, low psychosocial functioning, and high societal costs. Treatments for BPD have improved in the last decades. Dialectical behavior therapy (DBT) and Schema therapy (ST) have demonstrated efficacy in reducing BPD symptoms and costs. However, research has not compared these two treatment approaches. In addition, there is a lack of 'real world studies' that replicate positive findings in regular mental healthcare settings. Thus, the PROgrams for Borderline Personality Disorder (PRO*BPD) study will compare the (cost-) effectiveness of DBT and ST in structured outpatient treatment programs in the routine clinical setting of an outpatient clinic.

Methods/design: We aim to recruit 160 BPD patients, who will be randomly assigned to either DBT or ST. In both conditions, patients receive one group therapy and one individual therapy session/week for a maximum of 18 months. Both treatment programs have similar frameworks, which guarantee clinical equipoise. The primary outcome is a reduction of BPD-symptoms. Also, the costs related to BPD are assessed and an economic evaluation is performed from a societal perspective. Secondary outcomes examine other measures of BPD-typical and general psychopathology, comorbidity, quality of life, psychosocial functioning and participation. Data are collected prior to the beginning therapy and every six months until the end of therapy, as well as at six months, one year and two years of follow-up after the end of therapy. Finally, we conduct a qualitative study to understand patients' experiences with the two methods.

Discussion: The PRO*BPD study is the first randomized trial to compare the (cost-) effectiveness of DBT and ST. By examining the clinical effectiveness of a broad spectrum of outcome parameters, conducting an economic evaluation and assessing patients' experiences, this study will significantly advance our knowledge on psychotherapy for BPD and will provide insight into the treatment approaches that should be offered to different BPD patients from clinical, economic and stakeholder's perspectives.

Trial registration: German Clinical Trial Register, DRKS00011534 , Date of registration: 11/01/2017, retrospectively registered.

Keywords: Borderline personality disorder; Clinical effectiveness; Dialectical behavior therapy; Economic evaluation; Psychotherapy; Randomized controlled trial; Schema therapy.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the ethics committee of Lübeck University. Deviations from the protocol amendments will be submitted to the ethics committee of Lübeck University. Written informed consent is obtained from all participants prior to inclusion in the study.

Consent for publication

Not applicable.

Competing interests

EF, KH, VS, AA and US have provided trainings and/or published books on DBT and/or ST. NA, AS, TW, KJC and MH declare that they have no conflict of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of the study design. DBT = dialectical behavior therapy; ST = schema therapy, BPDSI = Borderline Personality Disorder Severity Index; BPD = Borderline Personality Disorder
See this image and copyright information in PMC

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