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The treatment allocation was assured by both psychiatrist and psychotherapist.Treatments of each branch were conducted simultaneously and both started the week after the enrollment in the study" (p 4).īlinding of outcome assessment (detection bias)Ĭomment: The raters were blind with regard to the group assignment of patients.Ĭomment: Intention‐to‐treat (ITT) analysis was used, dropout rates were low and balanced across groups.Ĭomment: ITT, low dropout that was balanced in each group Patients were enrolled by a psychiatrist of the MHS who communicated the generalities of the participants who signed the informed consent to BR and received from BR the group assignment. Quote: " was carried out by one author (BR), who was not involved in patients’ clinical management. The random allocation was generated using a random number table and was carried out by one author (BR), who was not involved in patients’ clinical management". Quote: "Patients, after providing their informed consent, were randomly assigned to SB‐APP in addition to Supervised Team Management (STM number of participants = 18) or to STM alone (number of participants = 17) groups. Random sequence generation (selection bias) Small sample size with no power calculation Identity disturbance, assessed by the CGI‐BPD item on identity distortionĭissociation and psychotic‐like symptoms, assessed by the CGI‐BPD item on dissociative symptomsĪttrition, in terms of patients lost after randomisation in each group
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Interpersonal problems, assessed by the CGI‐BPD item on disturbed relationshipsĪbandonment, assessed by the CGI‐BPD item on fear of abandonment Impulsivity, assessed by the CGI‐BPD item on impulsivity Psychosocial functioning, assessed by the Glocal Assessment of FunctioningĪnger, assessed by the CGI‐BPD item on angerĪffective instability, assessed by the CGI‐BPD item on affective instabilityĬhronic feeling of emptiness, assessed by CGI‐BPD item on a feeling of chronic emptiness Suicide‐related outcomes, assessed by the the Clinical Global Impression ‐ Modified (CGI‐BPD) item on suicidality and self‐damaging acts Self‐harm, assessed by the number of self‐harm incidents reported
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Proportions of participants taking standing medication during trial observation period: No further information on pharmacotherapyīorderline personality disorder severity, assessed by the Clinical Global Impression Scale (CGI) Drug treatment was prescribed during the first or second visit and modified if necessary during follow‐up.
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Three classes of drugs were used: antidepressants, mood stabilisers and atypical antipsychotics. Treatment name: supervised team management (STM) + sequential brief Adlerian psychodynamic psychotherapy (SB‐APP)Ĭoncomitant psychotherapy: supervised team management (STM) includes unstructured psychological support focused on socio‐relational impairment as well as rehabilitative interventions and mental health services training.Ĭoncomitant pharmacotherapy: supervised team management (STM) includes medications that were administered according to American Psychiatric Association (APA) guidelines for borderline personality disorder. Heavy use of mental health services throughout the prior yearĪbsence of an acute comorbid Axis I disorder requiring hospitalisationĪcute Axis I disorder requiring hospitalisation
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Mean age: 39.5 years (standard deviation = 9.4 range = 24‐57)Ĭomorbidity: of all the included participants, only 13 participants (37.1%) did not show a comorbid Axis I diagnosis.īorderline Personality Disorder diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM‐IV‐TR) criteria Means of assessment: Structured Clinical Interview for DSM (SCID) Patients who had been treated and clinically managed at least 1 year were eligible.ĭiagnosis of borderline personality disorder: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM‐IV‐TR) Method of recruitment of participants: screened through clinical notes of outpatient mental health service. Setting: outpatient, the Mental Health Center of Chivasso, Turin STM + sequential brief Adlerian psychodynamic psychotherapy (SB‐APP)ĭuration of trial: 10‐12 months intervention, 1 year follow‐up