title: Mentalization-based treatment in groups for adolescents with borderline personality disorder (BPD) or subthreshold BPD versus treatment as usual (M-GAB): study protocol for a randomized controlled trial.
abstract: Evidence-based outpatient psychotherapeutic programs are first-line treatment of borderline personality disorder (BPD). Early and effective treatment of BPD is crucial to the prevention of its individual, psychosocial, and economic consequences. However, in spite of recent advantages in diagnosing adolescent BPD, there is a lack of cost-effective evidence-based treatment programs for adolescents. Mentalization-based treatment is an evidence-based program for BPD, originally developed for adults.
  
  
  
  
  
  
  
  We will investigate whether a specifically designed mentalization-based treatment in groups is an efficacious treatment for adolescents with BPD or subthreshold BPD compared to treatment as usual. The trial is a four-center, two-armed, parallel-group, assessor-blinded randomized clinical superiority trial. One hundred twelve patients aged 14 to 17 referred to Child and Adolescent Psychiatric Clinics in Region Zealand are randomized to 1 year of either mentalization-based treatment in groups or treatment as usual. Patients will be included if they meet at least four DSM-5 criteria for BPD. The primary outcome is self-reported borderline features at discharge. Secondary outcomes will include self-harm, depression, BPD criteria, externalizing and internalizing symptoms, and social functioning, together with parental reports on borderline features, externalizing and internalizing symptoms. Measures of attachment and mentalization will be included as mediational variables. Follow-up assessment will take place at 3 and 12 months after end of treatment.
  
  
  
  This is the first randomized controlled trial to test the efficacy of a group-based mentalization-based treatment for adolescents with BPD or subthreshold BPD. If the results confirm our hypothesis, this trial will add to the treatment options of cost-effective treatment of adolescent BPD.
  
  
  
  Clinicaltrials.gov NCT02068326 , February 19, 2014.
authors.affiliation: Child and Adolescent Psychiatric Department, Region Zealand, Smedegade 16, 4000, Roskilde, Denmark. ebk@regionsjaelland.dk.|Psychiatric Research Unit, Region Zealand, Fælledvej 6, 4200, Slagelse, Denmark. ebk@regionsjaelland.dk.|Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark. ebk@regionsjaelland.dk.
authors.forename: Emma
authors.identifier: 0000-0002-4711-5417
authors.initials: E
authors.lastname: Beck
authors.affiliation: Child and Adolescent Psychiatric Department, Region Zealand, Smedegade 16, 4000, Roskilde, Denmark.|Psychiatric Research Unit, Region Zealand, Fælledvej 6, 4200, Slagelse, Denmark.
authors.forename: Sune
authors.initials: S
authors.lastname: Bo
authors.affiliation: Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark.
authors.forename: Matthias
authors.initials: M
authors.lastname: Gondan
authors.affiliation: Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark.
authors.forename: Stig
authors.initials: S
authors.lastname: Poulsen
authors.affiliation: Psychiatric Research Unit, Region Zealand, Fælledvej 6, 4200, Slagelse, Denmark.|Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark.
authors.forename: Liselotte
authors.initials: L
authors.lastname: Pedersen
authors.affiliation: Child and Adolescent Psychiatric Department, Region Zealand, Smedegade 16, 4000, Roskilde, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Pedersen
authors.affiliation: Psychiatric Research Unit, Region Zealand, Fælledvej 6, 4200, Slagelse, Denmark.|Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Simonsen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002985:Clinical Protocols; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D010551:Personality; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D012107:Research Design; D056345:Theory of Mind; D013997:Time Factors; D016896:Treatment Outcome
keywords: Adolescence; Borderline personality disorder; Group psychotherapy; Mentalization-based treatment; Mentalizing