Borderline Personality Disorder Clinical Trial
Official title:
Efficacy of a Dialectical Behavior Therapy and Acceptance Commitment Therapy Short Program for Prevention of Suicidal Behavior in Patients With Borderline Personality Disorder
According to the World Health Organization 1 death by suicide occurs every 40 seconds,
leading suicide prevention to one of the public health priority.
Borderline personality disorder (BPD) is a common condition affecting 6% of the population.
This disorder is characterized by unstable emotions, unstable mood, difficulties with
relationship and feer of abandonment.
BPD is also the psychopathology the most related to suicidal attempts. Indeed, up to 50% of
the patients admitted to hospital after a suicide attempt are diagnosis with a BPD.
Negative interpersonal events (events occurring between two people) are known as the main
stressor that trigger a suicidal attempt.
People with a BPD are highly sensitive to it. Unfortunately, patient care for this disorder
is limited. Pharmacological strategies didn't show any efficacy and psychotherapies, although
proven effective, are difficult to set up.
As BPD is strongly related to suicidal attempts it appears to be a good model to study
suicidal behavior. Thus, this study could improve knowledge in this field.
Suicidal behavior in patients receiving the standard therapy (dialectic behavioural therapy:
DBT) will be compared to patients receiving dialectical behavior therapy and acceptance
commitment therapy (ACT).
Clinical data reflecting how the participant is feeling will be collected as well.
An emotional dysregulation has been linked to suicidal behavior in patients with BPD.
Up to this date, no program had combined dialectical behavior therapy with acceptance
commitment therapy.
DBT aims to teach skills in four different fields : mindfulness, emotional regulation,
distress tolerance and interpersonal efficiency.
ACT helps to develop metacognitive skills and to identify what makes sense in one's life.
Because 75% of BPD patients are women, the study will only focus on them.
Patients will be evaluated during 4 visits :
- Inclusion : 1 or 2 weeks before the first session of therapy. During this visit patients
will undergo a clinical exam and will complete questionnaires.
- First follow-up visit : 6 months after the first session (for the experimental group) or
12 months after the first session (for the control group). During this visit will
undergo a clinical exam and will complete questionnaires. Therapeutic processes, therapy
satisfaction and cost- effectiveness ratio will be evaluated
- Second follow-up visit : 12 months after the first sessions (for the experimental group)
or 18 months after the first session (for the control group). During this visit will
undergo a clinical exam and will complete questionnaires. Therapeutic processes, and
cost- effectiveness ratio will be evaluated
- Third follow-up visit : 18 months after the first session (for the experimental group)
or 24 months after the first session (for the control group). During this visit will
undergo a clinical exam and will complete questionnaires. Therapeutic processes, and
cost- effectiveness ratio will be evaluated The hypothesis is that DBT+ ACT allows
reducing suicidal recidivism, reducing economical cost linked to BPD and improving
quality of life and functioning among patients.
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