Psychotherapy for personality disorders: Short-term day hospital psychotherapy versus outpatient individual therapy – a randomized controlled study

Abstract

This article describes the results of an eight-month follow-up investigation from a randomized controlled trial of day hospital psychotherapy (DHP) compared with outpatient individual psychotherapy (OIP) for patients with personality disorders (N=114). The patients were randomly assigned to either 18 weeks of day hospital treatment followed by long-term conjoint group and individual therapy (DHP), or outpatient individual psychotherapy (OIP). The main outcome measures were attrition rate, suicide attempts, suicidal thoughts, self-injury, psychosocial functioning, symptom distress, and interpersonal and personality problems. The study showed a low dropout rate and a moderate improvement on a broad range of clinical measures for both treatments. However, there was no indication of the superiority of one treatment over the other. Neither was there any indication that day hospital treatment was better for the most poorly functioning patients. Further studies will follow this group of patients for the next few years, the results of which may have implications for resource allocation and the organization of mental health services for patients with personality disorders.

Effectiveness of Outpatient, Day Hospital, and Inpatient Psychotherapeutic Treatment for Patients with Cluster B Personality Disorders

“…So until now, hardly any study has addressed possible differences in treatment effectiveness between different settings and across theoretical schools. Exceptions are the studies by Chiesa et al [36,37,38] comparing inpatient treatment and step-down/outpatient treatment and the study by Arnevik et al [39] comparing day hospital treatment and outpatient treatment. …”

Effectiveness of Different Modalities of Psychotherapeutic Treatment for Patients with Cluster C Personality Disorders: Results of a Large Prospective Multicentre Study

“…Investigators have compared different outpatient treatments [8,9,10,11,12,13], different day hospital treatments [14,15], and different inpatient treatments [16,17]. One recent study in Norway [18] compared outpatient and day hospital treatment for patients with all forms of PD, and found no significant superiority of one treatment over another at 8 months after the start of treatment. However, so far, no study has compared the effectiveness of treatments across widely differing settings and durations.…”

Favourable outcome of long-term combined psychotherapy for patients with borderline personality disorder: Six-year follow-up of a randomized study

“…Originally, UPP was a study including a mixed PD sample, and we have previously reported results for the total sample from the follow-up investigations at 8 months, 18 months, 3 years, and 6 years after the initial random assignment (Antonsen et al, 2014;Arnevik et al, 2009Arnevik et al, , 2010Gullestad et al, 2012). At six-year follow-up, differences between the two treatment conditions were below levels of significance, although different trends were observable (Antonsen et al, 2014).…”

“…Written informed consent was obtained from all included patients, and the project was approved by the Regional Ethics Committee in Norway. The subjects' characteristics, the original trial methodology, and the treatment details have previously been described in greater detail (Arnevik et al, 2009;Gullestad et al, 2012).…”

“…Individual therapists for both the CP and the OIP were recruited externally, mostly psychologists and psychiatrists working in private practice in the Oslo region. Additional information about the recruiting process and characteristics of therapists in UPP can be found elsewhere (Arnevik et al, 2009). …”