Priebe, Stefan, Bhatti, Nyla, Barnicot, Kirsten, Bremner, Stephen, Gaglia, Amy, Katsakou, Christina, Mosweu, Iris, McCrone, Paul and Zinkler, Martin (2012) Effectiveness and cost-effectiveness of dialectical behaviour therapy for self-harming patients with personality disorder: a pragmatic randomised controlled trial. Psychotherapy and Psychosomatics, 81 (6). 356 - 365. ISSN 0033-3190
Full text not available from this repository.Abstract
Background: A primary goal of dialectical behaviour therapy (DBT) is to reduce self-harm, but findings from empirical studies are inconclusive. The aim of this study was to assess the effectiveness and cost-effectiveness of DBT in reducing self-harm in patients with personality disorder. Methods: Participants with a personality disorder and at least 5 days of self-harm in the previous year were randomised to receive 12 months of either DBT or treatment as usual (TAU). The primary outcome was the frequency of days with self-harm; secondary outcomes included borderline personality disorder symptoms, general psychiatric symptoms, subjective quality of life, and costs of care. Results: Forty patients each were randomised to DBT and TAU. In an intention-to-treat analysis, there was a statistically significant treatment by time interaction for self-harm (incidence rate ratio 0.91, 95% CI 0.89-0.92, p < 0.001). For every 2 months spent in DBT, the risk of self-harm decreased by 9% relative to TAU. There was no evidence of differences on any secondary outcomes. The economic analysis revealed a total cost of a mean of 5,685 GBP (6,786 EUR) in DBT compared to a mean of 3,754 GBP (4,481 EUR) in TAU, but the difference was not significant (95% CI -603 to 4,599 GBP). Forty-eight per cent of patients completed DBT. They had a greater reduction in self-harm compared to dropouts (incidence rate ratio 0.78, 95% CI 0.76-0.80, p < 0.001). Conclusions: DBT can be effective in reducing self-harm in patients with personality disorder, possibly incurring higher total treatment costs. The effect is stronger in those who complete treatment. Future research should explore how to improve treatment adherence.
| Item Type: | Article |
|---|---|
| Official URL: | https://www.karger.com/Journal/Home/223864 |
| Additional Information: | © 2012 S. Karger AG, Basel |
| Divisions: | Health Policy |
| Subjects: | R Medicine > RC Internal medicine B Philosophy. Psychology. Religion > BF Psychology |
| Date Deposited: | 02 Sep 2020 07:33 |
| Last Modified: | 12 Dec 2024 02:18 |
| URI: | http://eprints.lse.ac.uk/id/eprint/106283 |
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