title: Joint crisis plans for people with borderline personality disorder: feasibility and outcomes in a randomised controlled trial.
abstract: BACKGROUND
  People with borderline personality disorder frequently experience crises. To date, no randomised controlled trials (RCTs) of crisis interventions for this population have been published.
  
  
  OBJECTIVE
  To examine the feasibility of recruiting and retaining adults with borderline personality disorder to a pilot RCT investigating the potential efficacy and cost-effectiveness of using a joint crisis plan.
  
  
  METHODS
  An RCT of joint crisis plans for community-dwelling adults with borderline personality disorder (trial registration: ISRCTN12440268). The primary outcome measure was the occurrence of self-harming behaviour over the 6-month period following randomisation. Secondary outcomes included depression, anxiety, engagement and satisfaction with services, quality of life, well-being and cost-effectiveness.
  
  
  RESULTS
  In total, 88 adults out of the 133 referred were eligible and were randomised to receive a joint crisis plan in addition to treatment as usual (TAU; n = 46) or TAU alone (n = 42). This represented approximately 75% of our target sample size and follow-up data were collected on 73 (83.0%) participants. Intention-to-treat analysis revealed no significant differences in the proportion of participants who reported self-harming (odds ratio (OR) = 1.9, 95% CI 0.53-6.5, P = 0.33) or the frequency of self-harming behaviour (rate ratio (RR) = 0.74, 95% CI 0.34-1.63, P = 0.46) between the two groups at follow-up. No significant differences were observed between the two groups on any of the secondary outcome measures or costs.
  
  
  CONCLUSIONS
  It is feasible to recruit and retain people with borderline personality disorder to a trial of joint crisis plans and the intervention appears to have high face validity with this population. However, we found no evidence of clinical efficacy in this feasibility study.
authors: Health Services & Population Research Department, Institute of Psychiatry, King's College London, UK.
authors: Rohan
authors: R
authors: Borschmann
authors: Barbara
authors: B
authors: Barrett
authors: Jennifer M
authors: JM
authors: Hellier
authors: Sarah
authors: S
authors: Byford
authors: Claire
authors: C
authors: Henderson
authors: Diana
authors: D
authors: Rose
authors: Mike
authors: M
authors: Slade
authors: Kim
authors: K
authors: Sutherby
authors: George
authors: G
authors: Szmukler
authors: Graham
authors: G
authors: Thornicroft
authors: Joanna
authors: J
authors: Hogg
authors: Paul
authors: P
authors: Moran
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D001883:Borderline Personality Disorder / Q000150:complications / Q000191:economics / Q000628:therapy*; D003362:Cost-Benefit Analysis; D003419:Crisis Intervention / Q000191:economics / Q000379:methods*; D003863:Depression / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D016728:Self-Injurious Behavior / Q000523:psychology; D016037:Single-Blind Method; D012946:Social Welfare / Q000191:economics / Q000706:statistics & numerical data; D016896:Treatment Outcome