Effectiveness of different modalities of psychotherapeutic treatment for patients with cluster C personality disorders: results of a large prospective multicentre study.
BACKGROUND
No previous studies have compared the effectiveness of different modalities of psychotherapeutic treatment, as defined by different settings and durations, for patients with cluster C personality disorders. The aim of this multicentre study was to compare the effectiveness of 5 treatment modalities for patients with cluster C personality disorders in terms of psychiatric symptoms, psychosocial functioning, and quality of life. The following treatment modalities were compared: long-term outpatient (more than 6 months), short-term day hospital (up to 6 months), long-term day hospital, short-term inpatient, and long-term inpatient psychotherapy.


METHODS
The study was conducted between March 2003 and June 2008 in 6 mental health care centres in the Netherlands, with a sample of 371 patients with a DSM-IV-TR axis-II cluster C diagnosis. Patients were assigned to 5 different modalities of psychotherapeutic treatment, and effectiveness was assessed at 12 months after baseline. An intention-to-treat analysis was conducted for psychiatric symptoms (Brief Symptom Inventory), psychosocial functioning (Outcome Questionnaire-45), and quality of life (EQ-5D), using multilevel statistical modelling. As the study was non-randomised, the propensity score method was used to control for initial differences.


RESULTS
Patients in all treatment groups had improved on all outcomes 12 months after baseline. Patients receiving short-term inpatient treatment showed more improvement than patients receiving other treatment modalities.


CONCLUSIONS
Psychotherapeutic treatment, especially in the short-term inpatient modality, is an effective treatment for patients with cluster C personality disorders.
Bartak
Anna
A
Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands. anna.bartak@deviersprong.nl
Spreeuwenberg
Marieke D
MD
Andrea
Helene
H
Holleman
Lot
L
Rijnierse
Piet
P
Rossum
Bert V
BV
Hamers
Elisabeth F M
EF
Meerman
Anke M M A
AM
Aerts
Janneke
J
Busschbach
Jan J V
JJ
Verheul
Roel
R
Stijnen
Theo
T
Emmelkamp
Paul M G
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D003192:Compulsive Behavior / Q000523:psychology; D003859:Dependent Personality Disorder / Q000175:diagnosis / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis / Q000628:therapy*; D011446:Prospective Studies; D011613:Psychotherapy / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult