Evaluating an Internet-Based Self-Management Intervention for Borderline (REVISIT)

February 21, 2020 updated by: Gaia AG

Research Evaluating the EffectiVeness of Adding an Internet-Based Self-Management Intervention to Usual Care in the Treatment of Borderline Personality Disorder - REVISIT BPD

The trial aims to evaluate the effectiveness of a novel internet intervention (Priovi), which was designed to introduce relevant schema therapy techniques to Persons with Borderline Personality Disorder (BPD). Therefore, 200 people with BPD will be recruited and randomized to two groups: (1) a control group, in which they may engage with any BPD treatment (Care-as-Usual, CAU) and receive access to Priovi after a delay of 12 months (i.e., CAU/wait list control group), or (2) to a treatment group that immediately receives 12-month access to Priovi and may also use CAU. The primary outcome measure is the score of the Borderline Personality Disorder Severity Index (BPDSI), collected at three, six and 12 month post-baseline.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

In the treatment of psychological disorders, web-based self-help programs can be very helpful, especially when combined with psychotherapy. However, up to this point, there are no respective programs for patients with Borderline Personality Disorder (BPD), although this disorder is associated with severe personal suffering and requires time-consuming therapy, which, in many cases, cannot be provided, due to the lack of therapeutic supply.

In this study, treatment effects of the web-based self-help program Priovi on BPD symptom severity when added to treatment as usual will be investigated. Priovi is a comprehensive program, which is conceptually and substantially based on the schema therapeutic approach used in BPD patients. It contains interactive dialogues that can be accessed via computer or smartphone, illustrations, audios and motivating text messages.

After a phone pre-screen and a diagnostic evaluation conducted by a psychiatrist, 200 patients suffering from BPD will be randomized into either the intervention group or into the waitlist control group. Priovi's duration of use is one year, measuring points will be determined before beginning of treatment (T0) as well as after 3 (T1), 6 (T2), 9 (T3) and 12 months (T4). The primary outcome variable will be the score of the Borderline Personality Disorder Severity Index (BPDSI), a highly reliable external assessment tool measuring BPD severity. Secondary outcome variables will be BPD symptom severity (as assessed by self-ratings), symptom severity of depression and anxiety as well as quality of life. The study will be collaboratively conducted by the University of Lübeck and the GAIA AG in Hamburg.

In this study, Priovi for BPD patients will be tested in a randomized controlled trial. It will be used as add-on therapy combined with any guideline therapy available to the respective patients. In doing so, the following hypothesis will be investigated: Compared to patients, who exclusively receive treatment as usual, the additional use of the self-help program in question will lead to a stronger decrease in BPD symptom severity.

Study Type

Interventional

Enrollment (Actual)

206

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Hamburg, Germany, 20144
        • GAIA AG

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Psychiatric diagnosis of BPD
  • BPDSI score of 15 or higher
  • Informed consent
  • German language proficiency
  • Willingness to participate in diagnostic and follow-up assessments as well as to see a -
  • Psychiatrist for validation of diagnosis
  • 18 years or older

Exclusion Criteria:

  • Psychotic disorder
  • Primary psychiatric diagnosis of an addictive disorder
  • Schizotypal personality disorder

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Priovi
Priovi is an Internet-administered intervention for people with BPD.
Priovi is an Internet intervention for people with BPD. Content is continuously adapted to patients' concerns and needs. Priovi is a comprehensive program, which is conceptually and substantially based on the schema therapeutic approach used in BPD patients. It contains interactive dialogues that can be accessed via computer or smartphone, illustrations, audios and motivating text messages. Techniques to cope with borderline symptoms (e.g., psychoeducation about modes, schemas and basic emotional needs in addition to relevant strategies to weaken, reduce and/or heal maladaptive schemas and modes) are conveyed in interactive sequences that are accompanied by audio recordings, illustrations, and worksheets. Patients are also prompted to regularly complete brief symptom severity self-monitoring questionnaires. Optional daily text messages with motivational content accompany the program. The program can be accessed for 365 days after registration.
Care as Usual: In the CAU/wait list control group, participants are free to continue to engage with any treatment they require (i.e., CAU). However, they will receive access to Priovi after 12 months post-baseline (i.e., wait list with respect to Priovi access).
Active Comparator: Care-as-Usual (CAU) / wait list
Additionaly, they will be informed about helpful and free available online self-help-proposals for BPD patients immediately after randomization.
Care as Usual: In the CAU/wait list control group, participants are free to continue to engage with any treatment they require (i.e., CAU). However, they will receive access to Priovi after 12 months post-baseline (i.e., wait list with respect to Priovi access).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Score of the Borderline Personality Disorder Severity Index (BPDSI) - The BPDSI is a semi-structured interview assessing the frequency and severity of manifestations of borderline personality disorder (BPD) during the last three months.
Time Frame: Changes from baseline to 3, 6 and 12 months
Semi-structured interview assessing BPD symptom frequency and severity
Changes from baseline to 3, 6 and 12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Severity of depressive symptoms, measured by Patient Health Questionnaire - 9 items (PHQ-9)
Time Frame: Changes from baseline to 3, 6, 9 and 12 months.

Self-report depression symptom severity measure.

Nine items, each of which is scored 0 to 3, providing a 0 to 27 severity score.

Depression Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.

Changes from baseline to 3, 6, 9 and 12 months.
GAD-7 (Generalized Anxiety Disorder Questionnaire)
Time Frame: Changes from baseline to 3, 6, 9 and 12 months.

Self-report anxiety symptom severity measure.

Seven items, each of which is scored 0 to 3, providing a 0 to 21 severity score.

Anxiety Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-21 severe.

Changes from baseline to 3, 6, 9 and 12 months.
EQ-5D (standardized instrument developed by the EuroQol Group as a measure of health-related quality of life.)
Time Frame: Changes from baseline to 3, 6, 9 and 12 months.
Self-report measure of quality of life symptoms.
Changes from baseline to 3, 6, 9 and 12 months.
BPD-Checklist short (Borderline personality Disorder Checklist short)
Time Frame: Changes from baseline to 3, 6, 9 and 12 months.
Self-report measure of BPD symptoms.
Changes from baseline to 3, 6, 9 and 12 months.
2 Items of CIUS-Long-brief (Compulsive Internet Use Scale)
Time Frame: Assessed at 3, 6, 9 and 12 months.

Adapted self-report measure assessing potential compulsive internet use.

two items, each of which is scored 1 to 5, providing a 2 to 10 severity score with higher values representing a worse outcome

Assessed at 3, 6, 9 and 12 months.
NEQ (negative effects questionnaire)
Time Frame: Assessed at baseline, 3, 6, 9 and 12 months.

Self-report measure of potential negative effects of the treatment.

qualitative measure.

Assessed at baseline, 3, 6, 9 and 12 months.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Jan Philipp Klein, Dr. med., University of Lübeck, Zentrum für Integrative Psychiatrie ZiP gGmbH

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 29, 2018

Primary Completion (Actual)

January 29, 2020

Study Completion (Actual)

January 29, 2020

Study Registration Dates

First Submitted

January 23, 2018

First Submitted That Met QC Criteria

January 25, 2018

First Posted (Actual)

February 1, 2018

Study Record Updates

Last Update Posted (Actual)

February 24, 2020

Last Update Submitted That Met QC Criteria

February 21, 2020

Last Verified

February 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • REVISIT-BPD Trial

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Yes

IPD Plan Description

Anonymized individual participant data shall be made available upon request for projects such as meta-analyses after completion of the study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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