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Background: Although it is now possible to diagnose Borderline Personality Disorder (BPD) in adolescents younger than 18 years according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V), and studies indicates that BPD can be reliably diagnosed in adolescence, only a few evidence based treatment programmes for adolescent BPD exists. Mentalization-based treatment (MBT), including group psychotherapy, has repeatedly shown to be effective in treating adult BPD, but in the case of adolescents, only individual MBT have been tested and found to be effective.
Aims/hypotheses: We will test whether group based MBT (MBT-G), including an introductory programme for patients (MBT-I) and their parents (MBT-P) is more effective than Treatment As Usual (TAU) in treating adolescents with BPD or subthreshold BPD.
Methods/Design: 112 patients referred to child and adolescent psychiatric clinics in Region Zealand will be randomized to either MBT or TAU. Inclusion criteria: Meeting DSM-V BPD-criteria at the threshold (five criteria) or sub threshold level (4 criteria). Follow-up will be at three and 12 months.
Discussion: Early intervention is especially important in relation to personality psychopathology and has long-term benefits for patients, their families and society. In addition to being cost effective, using the group modality in the treatment of BPD may have several advantages. This is the first Randomized Controlled Trial (RCT) to test the effectiveness of MBT in groups for adolescents.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mentalization Based Treatment | Experimental | the experimental intervention is a year-long manualized program that comprises four components:
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| Treatment As Usual | Active Comparator | Participants randomized to the control group will receive Treatment As Usual (TAU). TAU is defined as comprising at least 12 monthly individual supportive sessions provided by non-MBT trained mental health professionals in the Department of Child and Adolescent Psychiatry in Region Zealand. Additional supportive sessions or other types of intervention may be offered to the patients according to the needs of the patients as evaluated by mental health professionals responsible for his/hers treatment. Hence, TAU may vary considerably in number and type of intervention across clinics and patients. All mental health services delivered during the treatment period to patients in the TAU group will be monitored and registered. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mentalization Based Treatment | Behavioral |
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| |
| Measure | Description | Time Frame |
|---|---|---|
| The Borderline Personality Feature Scale for Children (BPFS-C) | Change from Baseline in BPFS-C at 40 weeks | |
| The Borderline Personality Feature Scale for Children (BPFS-C) | Change from Baseline in BPFS-C at 10 weeks | |
| The Borderline Personality Feature Scale for Children (BPFS-C) | Change from baseline at 20 weeks | |
| The Borderline Personality Feature Scale for Children (BPFS-C) | Change from baseline at 30 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Becks Depression Inventory for Youth | Change from Baseline in at 10 weeks | |
| Becks Depression Inventory for Youth | Change from Baseline in at 20 weeks | |
| Becks Depression Inventory for Youth |
| Measure | Description | Time Frame |
|---|---|---|
| Experience of Close Relationships Inventory (ECR) | Treatment related variable (mediator) | Change from baseline at 40 weeks |
| Experience of Close Relationships Inventory (ECR) | Treatment related variable (mediator) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Erik Simonsen, PhD | Psychiatric Research Unit, Region Zealand, Denmark | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Child and Adolescent Psychiatric Department, Region Zealand | Roskilde | Region Sjælland | 4000 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32388627 | Derived | Jorgensen MS, Storebo OJ, Bo S, Poulsen S, Gondan M, Beck E, Chanen AM, Bateman A, Pedersen J, Simonsen E. Mentalization-based treatment in groups for adolescents with Borderline Personality Disorder: 3- and 12-month follow-up of a randomized controlled trial. Eur Child Adolesc Psychiatry. 2021 May;30(5):699-710. doi: 10.1007/s00787-020-01551-2. Epub 2020 May 9. | |
| 32368793 |
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| ID | Term |
|---|---|
| D001883 | Borderline Personality Disorder |
| ID | Term |
|---|---|
| D010554 | Personality Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D000088042 | Mentalization-Based Therapy |
| D013812 | Therapeutics |
| ID | Term |
|---|---|
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
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| Treatment As Usual |
| Behavioral |
Treatment As Usual |
|
| Change from Baseline in at 30 weeks |
| Becks Depression Inventory for Youth | Change from Baseline in at 40 weeks |
| The Risk-Taking and Self-Harm Inventory for adolescents (RTSHIA) | Change from baseline at 40 weeks |
| The Risk-Taking and Self-Harm Inventory for adolescents (RTSHIA) | change from baseline at 10 weeks |
| The Risk-Taking and Self-Harm Inventory for adolescents (RTSHIA) | change from baseline at 20 weeks |
| The Risk-Taking and Self-Harm Inventory for adolescents (RTSHIA) | Chage from baseline at 30 weeks |
| ZAN-BPD Zanarini Rating Scale for Borderline Personality Disorder | Change from baseline at 40 weeks |
| The Health of the Nation Outcome Scale for Children and Adolescent (HoNOSCA) | Change from baseline at 40 weeks |
| The Childrens' Global Assessment Scale (CGAS) | Change from baseline at 40 weeks |
| The childhood behaviour checklist (CBCL, Parental outcome measure) | Change from baseline at 40 weeks |
| The childhood behaviour checklist (CBCL, Parental outcome measure) | Change from baseline at 10 weeks |
| The childhood behaviour checklist (CBCL, Parental outcome measure) | Change from baseline at 20 weeks |
| The childhood behaviour checklist (CBCL, Parental outcome measure) | Change from baseline at 30 weeks |
| The borderline personality feature scale for Children - parental version (BPFS-P) | Change from baseline at 40 weeks |
| The borderline personality feature scale for Children - parental version (BPFS-P) | Change from baseline at 10 weeks |
| The borderline personality feature scale for Children - parental version (BPFS-P) | Change from baseline at 20 weeks |
| The borderline personality feature scale for Children - parental version (BPFS-P) | Change from baseline at 30 weeks |
| Number of patients' hospital admissions and visits to the emergency room | Change from baseline at 40 weeks |
| The Youth Self-Report (YSR) | Change from baseline at 10 weeks |
| The Youth Self-Report (YSR) | Change from baseline at 20 weeks |
| The Youth Self-Report (YSR) | Change from baseline at 30 weeks |
| The Youth Self-Report (YSR) | Change from baseline at 40 weeks |
| Change from baseline at 10 weeks |
| Experience of Close Relationships Inventory (ECR) | Treatment related variable (mediator) | Change from baseline at 20 weeks |
| Experience of Close Relationships Inventory (ECR) | Treatment related variable (mediator) | Change from baseline at 30 weeks |
| Inventory of Parent and Peer Attachment - Revised (IPPA-R) | Treatment related variable (mediator) | Change from baseline at 40 weeks |
| Inventory of Parent and Peer Attachment - Revised (IPPA-R) | Treatment related variable (mediator) | Change from baseline at 10 weeks |
| Inventory of Parent and Peer Attachment - Revised (IPPA-R) | Treatment related variable (mediator) | Change from baseline at 20 weeks |
| Inventory of Parent and Peer Attachment - Revised (IPPA-R) | Treatment related variable (mediator) | Change from baseline at 30 weeks |
| Reflective Function Questionnaire for Youth (RFQ-Y) | Treatment related variable (mediator) | Change from baseline at 40 weeks |
| Reflective Function Questionnaire for Youth (RFQ-Y) | Treatment related variable (mediator) | Change from baseline at 10 weeks |
| Reflective Function Questionnaire for Youth (RFQ-Y) | Treatment related variable (mediator) | Change from baseline 20 weeks |
| Reflective Function Questionnaire for Youth (RFQ-Y) | Treatment related variable (mediator) | Change from baseline at 30 weeks |
| Storebo OJ, Stoffers-Winterling JM, Vollm BA, Kongerslev MT, Mattivi JT, Jorgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020 May 4;5(5):CD012955. doi: 10.1002/14651858.CD012955.pub2. |
| 31702058 | Derived | Beck E, Bo S, Jorgensen MS, Gondan M, Poulsen S, Storebo OJ, Fjellerad Andersen C, Folmo E, Sharp C, Pedersen J, Simonsen E. Mentalization-based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial. J Child Psychol Psychiatry. 2020 May;61(5):594-604. doi: 10.1111/jcpp.13152. Epub 2019 Nov 8. |
| 27405522 | Derived | Beck E, Bo S, Gondan M, Poulsen S, Pedersen L, Pedersen J, Simonsen E. Mentalization-based treatment in groups for adolescents with borderline personality disorder (BPD) or subthreshold BPD versus treatment as usual (M-GAB): study protocol for a randomized controlled trial. Trials. 2016 Jul 12;17(1):314. doi: 10.1186/s13063-016-1431-0. |