title: [Effectiveness of an integrated treatment for severe personality disorders. A 36-month pragmatic follow-up].
abstract: BACKGROUND
  Over the past 25 years, several studies have shown the efficacy of a number of psychological interventions for severe personality disorders. However, the generalizability of these positive results from long traditional research settings to more ordinary ones has been questioned, requiring a need for replication in pragmatic studies.
  
  
  METHODS
  This pragmatic study compares hospitalizations and Emergency Room visits before and during a 6-month therapeutic program for severe personality disorders, and at 36 months after starting it. The therapeutic program, which integrates several specific interventions within a coherent framework, was carried out in an ordinary clinical setting. Fifty-one patients, evaluated according DSM-IV criteria by using the Spanish version of the Structured Clinical Interview for Personality Disorders (SCID-II), were included.
  
  
  RESULTS
  The clinical characteristics showed a group of severely disturbed patients, of which 78.4% met criteria for borderline personality disorder. The percentage of patients hospitalized and visiting the Emergency Room, as well as the number of days of hospitalization and Emergency Room visits was significantly reduced during the treatment, and this improvement was maintained throughout.
  
  
  CONCLUSIONS
  An integrated treatment for severe personality disorders could be effective in preventing reliance on readmissions, or prolonged hospital stays, when it is implemented by clinicians in ordinary clinical settings.
authors.affiliation: Instituto de Neuropsiquiatría y Adicciones (INAD), Parc de Salut Mar, Centro de Investigación en Red de Salud Mental (CIBERSAM), Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: Flanamoliner@parcdesalutmar.cat.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lana
authors.affiliation: Instituto de Neuropsiquiatría y Adicciones (INAD), Parc de Salut Mar, Centro de Investigación en Red de Salud Mental (CIBERSAM), Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Sánchez-Gil
authors.affiliation: Centro de Salud Mental Infantil y Juvenil de Santa Coloma de Gramenet, Fundación Vidal i Barraquer, Santa Coloma de Gramenet, Barcelona, España.
authors.forename: Laia
authors.initials: L
authors.lastname: Ferrer
authors.affiliation: Centro de Salud Mental Infantil y Juvenil de Granollers, Servei de Salut Mental, Hospital Sant Joan de Déu, Granollers, Barcelona, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: López-Patón
authors.affiliation: Instituto de Neuropsiquiatría y Adicciones (INAD), Parc de Salut Mar, Centro de Investigación en Red de Salud Mental (CIBERSAM), Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Lia
authors.initials: L
authors.lastname: Litvan
authors.affiliation: Instituto de Neuropsiquiatría y Adicciones (INAD), Parc de Salut Mar, Centro de Investigación en Red de Salud Mental (CIBERSAM), Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Susana
authors.initials: S
authors.lastname: Marcos
authors.affiliation: Hospital Miguel Servet, Sector II, Zaragoza, España.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Sierra
authors.affiliation: Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Barcelona, Barcelona, España.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Soldevilla
authors.affiliation: Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Barcelona, Barcelona, España.
authors.forename: Guillem
authors.initials: G
authors.lastname: Feixas
authors.affiliation: Instituto de Neuropsiquiatría y Adicciones (INAD), Parc de Salut Mar, Centro de Investigación en Red de Salud Mental (CIBERSAM), Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Víctor
authors.initials: V
authors.lastname: Pérez
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000188:drug therapy / Q000628:therapy; D003131:Combined Modality Therapy; D003631:Day Care, Medical / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007406:Interview, Psychological; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010554:Personality Disorders / Q000188:drug therapy / Q000628:therapy*; D015397:Program Evaluation; D011613:Psychotherapy / Q000379:methods*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012959:Socioeconomic Factors; D013030:Spain; D016896:Treatment Outcome; D000092864:Suicide Prevention
chemical_list: D011619:Psychotropic Drugs
keywords: Borderline personality disorder; Estudio clínico pragmático; Personality disorder; Pragmatic clinical study; Psicoterapia; Psychotherapy; Trastorno borderline de la personalidad; Trastorno de personalidad