Outcomes for 18 to 25‐year‐olds with borderline personality disorder in a dedicated young adult only DBT programme compared to a general adult DBT programme for all ages 18+

Lyng, Jim; Swales, Michaela; Hastings, Richard P.; Millar, Tracy; Duffy, Daniel

doi:10.1111/eip.12808

Cited by 9 publications

(4 citation statements)

References 51 publications

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“…One RCT did not report significance results. Non-randomised experiments, observational studies, quasi experiment, and natural experiment with pre-post comparison ( n = 3) [ 94 – 96 ] Sample size: 20–100 ( n = 2); > 100 ( n = 1). Date: 2010–2019 ( n = 3).…”

Section: Resultsmentioning

confidence: 99%

Current state of the evidence on community treatments for people with complex emotional needs: a scoping review

Ledden

Rains²,

Schlief³

et al. 2022

BMC Psychiatry

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Background Improving the quality of care in community settings for people with ‘Complex Emotional Needs’ (CEN—our preferred working term for services for people with a “personality disorder” diagnosis or comparable needs) is recognised internationally as a priority. Plans to improve care should be rooted as far as possible in evidence. We aimed to take stock of the current state of such evidence, and identify significant gaps through a scoping review of published investigations of outcomes of community-based psychosocial interventions designed for CEN. Methods We conducted a scoping review with systematic searches. We searched six bibliographic databases, including forward and backward citation searching, and reference searching of relevant systematic reviews. We included studies using quantitative methods to test for effects on any clinical, social, and functioning outcomes from community-based interventions for people with CEN. The final search was conducted in November 2020. Results We included 226 papers in all (210 studies). Little relevant literature was published before 2000. Since then, publications per year and sample sizes have gradually increased, but most studies are relatively small, including many pilot or uncontrolled studies. Most studies focus on symptom and self-harm outcomes of various forms of specialist psychotherapy: most result in outcomes better than from inactive controls and similar to other specialist psychotherapies. We found large evidence gaps. Adaptation and testing of therapies for significant groups (e.g. people with comorbid psychosis, bipolar disorder, post-traumatic stress disorder, or substance misuse; older and younger groups; parents) have for the most part only reached a feasibility testing stage. We found little evidence regarding interventions to improve social aspects of people’s lives, peer support, or ways of designing effective services. Conclusions Compared with other longer term mental health problems that significantly impair functioning, the evidence base on how to provide high quality care for people with CEN is very limited. There is good evidence that people with CEN can be helped when specialist therapies are available and when they are able to engage with them. However, a much more methodologically robust and substantial literature addressing a much wider range of research questions is urgently needed to optimise treatment and support across this group.

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Section: Resultsmentioning

confidence: 99%

Current state of the evidence on community treatments for people with complex emotional needs: a scoping review

Ledden

Rains²,

Schlief³

et al. 2022

BMC Psychiatry

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“…Our YAS offers DBT, which has been proven effective in many randomized controlled trials (Cristea et al, 2017). Lyng et al (2020) also reported better outcomes in relation to symptom severity and psychopathology when DBT is delivered exclusively to young adults, possibly due to group cohesion.…”

Section: Discussionmentioning

confidence: 97%

The young adult service: An evaluation of a youth mental health service in the independent sector in Ireland

Bond

Power

2020

Early Intervention Psych

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Aims Increasing concerns about the specific needs and rates of mental illness among young adults have spurred the development of youth mental health services. Yet few outcome studies exist. This study aims to evaluate a young adult service in an independent mental health sector in Ireland. Methods This is a service evaluation using a retrospective, descriptive and naturalistic study design. Routine demographic, diagnostic and service usage data were collected at entry into the service. Outcomes were recorded at discharge from the service using the Clinical Global Impression (CGI) improvement scores. Factors associated with better or worse outcomes were analyzed. Results Five hundred and sixty‐seven young adults were assessed and managed during a 3‐year period by the Young Adult Service. Their characteristics fell midway between adolescent and adult mental health service populations. They had high levels of Axis I & II co‐morbidities reflecting the complex and fluid nature of emerging conditions in this age group. The majority (62.8%) had clinically improved by the end of follow‐up. Outcomes were significantly better in those who were hospitalized, prescribed psychotropic medication, received 1:1 psychology sessions and attended a group‐based psychology program or group program for specific disorders. One hundred and sixty‐six patients (29.3%) dropped out of follow‐up. Drop out was associated with longer time spent in the service, being treated solely in the community, without medication, not having a developmental disorder and not transferring from CAMHS. Conclusions This study demonstrates that it is possible to establish an effective youth mental health service with favourable outcomes within a broader mental health system. It provides a benchmark for similar services, bridging the gap between adolescent and adult mental health services.

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“…These diseases have a profound socioeconomic impact and high prevalence (0.8-2.4% for BD (8,9), 2.5-15% for ADHD (10), and 2.7-6% for BPD (11,12), see also (13)), and are often comorbid with one another (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). Increasing evidence shows substantial benefits of early interventions in individuals at risk for EDD (27)(28)(29)(30)(31), but there is a compelling need for deeper pathophysiological insights.…”

Section: Emotion Regulation and (Neuro)inflammation In Emotion Dysreg...mentioning

confidence: 99%

Inflammation and emotional regulation: a narrative review of evidence and mechanisms in emotional dysregulation disorders

Petruso¹,

Giff²,

Milano³

et al. 2023

Preprint

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Emotion dysregulation (ED) describes a difficulty with the modulation of which emotions are felt, as well as when and how these emotions are experienced or expressed. It is a focal overarching symptom in many severe and prevalent neuropsychiatric diseases, including bipolar disorders (BD), attention deficit and hyperactivity disorder (ADHD), and borderline personality disorder (BPD). In all these disorders, ED can manifest through symptoms of depression, anxiety, or affective lability. Considering the many similarities in symptoms between BD, ADHD, and BPD, a transdiagnostic approach is a promising lens of investigation. Mounting evidence supports the role of peripheral inflammatory markers and stress in the multifactorial aetiology and physiopathology of BD, ADHD, and BPD. Of note, neural circuits that regulate emotions appear particularly vulnerable to inflammatory insults and peripheral inflammation, which can impact the neuroimmune milieu of the central nervous system. Thus far, few studies have examined the link between ED and inflammation in BD, ADHD, and BPD. To our knowledge, no specific work has provided a critical comparison of the results from these disorders. To fill this gap in the literature, we review the known associations and mechanisms linking ED and inflammation in general, and clinically, in BD, ADHD, and BD. Our narrative review begins with an examination of the routes linking ED and inflammation, followed by a discussion of disorder-specific results accounting for methodological limitations and relevant confounding factors. Finally, we critically discuss both correspondences and discrepancies in the results and comment on potential vulnerability markers and promising therapeutic interventions.

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Outcomes for 18 to 25‐year‐olds with borderline personality disorder in a dedicated young adult only DBT programme compared to a general adult DBT programme for all ages 18+

Cited by 9 publications

References 51 publications

Current state of the evidence on community treatments for people with complex emotional needs: a scoping review

Current state of the evidence on community treatments for people with complex emotional needs: a scoping review

The young adult service: An evaluation of a youth mental health service in the independent sector in Ireland

Inflammation and emotional regulation: a narrative review of evidence and mechanisms in emotional dysregulation disorders

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