title: Disappointed Love and Suicide: A Randomized Controlled Trial of "Abandonment Psychotherapy" Among Borderline Patients.
abstract: To determine whether ambulatory psychotherapy targeted to abandonment experiences and fears can reduce suicidality and improve outcome in borderline patients referred to the emergency room with major depressive disorder and self-destructive behavior severe enough to require medical/surgical treatment and a brief psychiatric hospitalization. A total of 170 subjects were randomized at hospital discharge into three treatment groups: treatment as usual (TAU), abandonment psychotherapy delivered by certified psychotherapists, and abandonment psychotherapy delivered by nurses. Assessments were performed before randomization and at 3-month follow-up. Continued suicidality and other outcome measures were significantly worse in the treatment-as-usual as compared to both abandonment psychotherapy groups, but there were no differences between the two psychotherapy groups. These results suggest the efficacy of manualized psychotherapy that specifically targets the abandonment fears and experiences that are so common as precipitants to suicidal and self-destructive acts in borderline patients. It does not appear that formal psychotherapy training is associated with better outcomes.
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Andreoli
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Y
authors.initials: Y
authors.lastname: Burnand
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: M-F
authors.initials: MF
authors.lastname: Cochennec
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Ohlendorf
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Frambati
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Gaudry-Maire
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Th
authors.initials: T
authors.lastname: Di Clemente
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Hourton
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Lorillard
authors.affiliation: Psychiatry Department, University of Geneva, Service de liaison psychiatrique et d'intervention de crise, Geneva University Hospital, Geneva, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Canuto
authors.affiliation: Duke University, Durham, North Carolina (Emeritus).
authors.forename: A
authors.initials: A
authors.lastname: Frances
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001883:Borderline Personality Disorder / Q000523:psychology* / Q000628:therapy*; D003865:Major Depressive Disorder / Q000523:psychology; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008149:Love; D008297:Male; D011613:Psychotherapy / Q000379:methods*; D012017:Referral and Consultation; D016728:Self-Injurious Behavior / Q000523:psychology; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult