Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: randomised controlled trial.
BACKGROUND
No accepted intervention exists for borderline personality disorder presenting in adolescence.


OBJECTIVE
To compare the effectiveness of up to 24 sessions of cognitive analytic therapy (CAT) or manualised good clinical care (GCC) in addition to a comprehensive service model of care.


METHODS
In a randomised controlled trial, CAT and GCC were compared in out-patients aged 15-18 years who fulfilled two to nine of the DSM-IV criteria for borderline personality disorder. We predicted that, compared with the GCC group, the CAT group would show greater reductions in psychopathology and parasuicidal behaviour and greater improvement in global functioning over 24 months.


RESULTS
Eighty-six patients were randomised and 78 (CAT n=41; GCC n=37) provided follow-up data. There was no significant difference between the outcomes of the treatment groups at 24 months on the pre-chosen measures but there was some evidence that patients allocated to CAT improved more rapidly. No adverse effect was shown with either treatment.


CONCLUSIONS
Both CAT and GCC are effective in reducing externalising psychopathology in teenagers with sub-syndromal or full-syndrome borderline [corrected] personality disorder. Larger studies are required to determine the specific value of CAT in this population.
Chanen
Andrew M
AM
ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Australia. achanen@unimelb.edu.au
Jackson
Henry J
HJ
McCutcheon
Louise K
LK
Jovev
Martina
M
Dudgeon
Paul
P
Yuen
Hok Pan
HP
Germano
Dominic
D
Nistico
Helen
H
McDougall
Emma
E
Weinstein
Caroline
C
Clarkson
Verity
V
McGorry
Patrick D
PD
D000293:Adolescent; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D042241:Early Diagnosis; D005500:Follow-Up Studies; D006801:Humans; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome