Predictors of treatment outcome of Inpatient Psychotherapy for Adolescents with personality pathology

Abstract

Little is known about the effectiveness of treatment programmes for personality disordered adolescents. This study investigates the treatment outcome of Inpatient Psychotherapy for Adolescents (IPA), i.e. an intensive programme for treatment refractory adolescents with personality pathology. In addition, this study examines predictors of treatment outcome. One hundred and nine adolescents admitted for treatment of their personality problems were followed up during their stay in IPA. Axis I and Axis II disorders were measured using semi-structured interviews, and the adolescents completed several questionnaires to measure symptom severity (global indices of distress), personality styles and functioning, and quality of life at both start and 12 months after start of treatment. Patients showed improvement in level of symptom severity, personality functioning and quality of life (d ranging from 0.49 to 0.97). As for level of symptom severity, 29% of the adolescents moved into a normative range of symptom severity. Higher levels of self-criticism significantly predicted poorer outcome in terms of symptom severity. Type of personality disorder did not predict treatment outcome. IPA is a potentially effective treatment programme for (a subgroup of) treatment refractory adolescents with personality pathology.

Psychological symptoms, early maladaptive schemas and schema modes: predictors of the outcome of group schema therapy in patients with personality disorders

“…Neither did frequency or type of PD have any effect on psychological symptom relief at treatment termination. This finding is in line with the study of Feenstra et al (2014), who concluded that type of personality disorder and frequency of traits were not predictive for change in psychological symptoms at treatment termination in Inpatient Psychotherapy for Adolescents.…”

CAPMH health-related quality of life among adolescent psychiatric outpatients: a 12-month follow-up study among 12–14-year-old Finnish boys and girls

“…In a study by Granö et al [19], a need-adapted, family- and community-oriented intervention model improved HRQoL of help-seeking adolescents with mental health problems. A significant improvement in QoL was also seen in a study investigating the treatment outcome of inpatient psychotherapy among personality disordered adolescents [20] and in a study exploring adolescent mentalization-based integrative treatment among adolescents with anxiety, depression, or psychotic symptoms [21]. Recently, an intervention model derived from psychodynamic, milieu, and cognitive therapies was shown to improve QoL in adolescents with different psychiatric diagnoses [22].…”

Personality Disorder in Childhood and Adolescence comes of Age: a Review of the Current Evidence and Prospects for Future Research

“…For child psychotherapy, these numbers may be even higher, with up to 24% of children between the ages of 4 and 17 years who are treated in community mental health settings deteriorating (227). A recent uncontrolled treatment study of adolescent inpatients with PD found that 26% of the participants showed reliable change and moved into a normative range of symptom severity; the rest of the participants did not change or only displayed modest symptom reduction, and 9% deteriorated (228). Data from an RCT study of CAT for PD in adults have also demonstrated that TAU can act as a "nocebo" condition in which harmful effects arise from a placebo treatment (161,229,230).…”