Step-down versus outpatient psychotherapeutic treatment for personality disorders: 6-year follow-up of the Ullevål personality project

BMC Psychiatry

Theresa Wilberg²  Sigmund Karterud¹  Elfrida H Kvarstein¹  Øyvind Urnes¹  Geir Pedersen¹  Merete S Johansen¹  Benjamin Hummelen²  Anne Kamps³  Ole Klungsøyr²  Bjørnar T Antonsen¹ 

[1] Department of Personality Psychiatry, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway;Department of Research and Development, Clinic for Mental Health and Addiction, Oslo University Hospital, Oslo, Norway;Department of Psychiatry, Lovisenberg Diaconal hospital, Oslo, Norway

关键词: Long-term follow-up;    Level of care;    Psychotherapy;    Personality disorder;   

Others  :  1123628
DOI  :  10.1186/1471-244X-14-119

 received in 2013-08-20, accepted in 2014-04-10,  发布年份 2014

【 摘 要 】

Background

Although psychotherapy is considered the treatment of choice for patients with personality disorders (PDs), there is no consensus about the optimal level of care for this group of patients. This study reports the results from the 6-year follow-up of the Ullevål Personality Project (UPP), a randomized clinical trial comparing outpatient individual psychotherapy with a long-term step-down treatment program that included a short-term day hospital treatment followed by combined group and individual psychotherapy.

Methods

The UPP included 113 patients with PDs. Outcome was evaluated after 8 months, 18 months, 3 years and 6 years and was based on a wide range of clinical measures, such as psychosocial functioning, interpersonal problems, symptom severity, and axis I and II diagnoses.

Results

At the 6-year follow-up, there were no statistically significant differences in outcome between the treatment groups. Effect sizes ranged from medium to large for all outcome variables in both treatment arms. However, patients in the outpatient group had a marked decline in psychosocial functioning during the period between the 3- and 6-year follow-ups; while psychosocial functioning continued to improve in the step-down group during the same period. This difference between groups was statistically significant.

Conclusions

The findings suggest that both hospital-based long-term step-down treatment and long-term outpatient individual psychotherapy may improve symptoms and psychosocial functioning in poorly functioning PD patients. Social and interpersonal functioning continued to improve in the step-down group during the post-treatment phase, indicating that longer-term changes were stimulated during treatment.

Trial registration

NCT00378248.

【 授权许可】

   
2014 Antonsen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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