Dynamic deconstructive psychotherapy versus optimized community care for borderline personality disorder co-occurring with alcohol use disorders: a 30-month follow-up.
Patients having co-occurring borderline personality disorder and alcohol use disorders represent a common, but particularly severe and refractory subgroup. An individual, time-limited treatment, dynamic deconstructive psychotherapy (DDP), has been shown to be effective for this subgroup, but long-term outcomes are not known. Participants were recruited from a sample of 30 patients enrolled in a 12-month randomized controlled trial of DDP versus optimized community care (OCC). Outcomes were assessed after an additional 18 months of naturalistic follow-up. DDP participants received an equivalent amount of individual treatment and less group therapy than those receiving OCC, but demonstrated large, sustained treatment effects over a broad range of outcomes and achieved significantly greater improvement in core BPD symptoms, depression, parasuicide, and recreational drug use over the 30-month study. These results suggest that DDP is a cost-effective treatment that can lead to broad and sustained improvement for the dually diagnosed subgroup.
Gregory
Robert J
RJ
Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY 13210, USA. gregoryr@upstate.edu
DeLucia-Deranja
Evan
E
Mogle
Jacqueline A
JA
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000191:economics / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D001883:Borderline Personality Disorder / Q000191:economics / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D019090:Case Management; D003131:Combined Modality Therapy / Q000191:economics; D003156:Community Mental Health Services / Q000191:economics; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011575:Psychoanalytic Therapy / Q000191:economics / Q000379:methods*; D055815:Young Adult