- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03677037
The Short-Term MBT Project (MBT-RCT)
Short-term Versus Long-term Mentalization-based Therapy for Outpatients With Subthreshold or Diagnosed Borderline Personality Disorder: a Randomized Clinical Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Psychotherapy for borderline personality disorder is often lengthy and resource-intensive. Mentalization-based therapy is an example of an evidence-based treatment that currently has empirical support as an 18-months outpatient program for borderline personality disorder. However, this duration is rarely available, and the long and costly treatment combined with a highly prevalent disorder result in insufficient access to evidence-based care.
The trial is an investigator-initiated, single-centre, assessor-blinded, randomized clinical superiority trial of short-term (20 weeks) compared to long-term (14 months) outpatient mentalization-based therapy for borderline personality disorder or subthreshold borderline personality disorder. Participants will be recruited from the Outpatient Clinic for Personality Disorders at Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark. Participants will be assessed at trial intake using the Mini International Neuropsychiatric Interview and the Structured Clinical Interview for DSM-5 Personality Disorders. Participants will be included if they meet a minimum of four DSM-5 criteria for borderline personality disorder. Participants will be assessed blind to treatment allocation at baseline, and at 8, 16, and 24 months after randomization.
The primary outcome is severity of borderline symptomatology assessed using the Zanarini Rating Scale for Borderline Personality Disorder interview. Secondary outcomes include self-harm incidents, functional impairment (Work and Social Adjustment Scale), quality of life (Short-Form Health Survey), and global functioning (Global Assessment of Functioning scale). Psychiatric symptoms (Symptom Checklist 90) will be included as an exploratory outcome. Measures of personality functioning, attachment, group alliance, borderline symptoms and mentalization skills will be included as predictor and mediator variables.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Gentofte, Denmark, 2820
- Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria exclusive to the Outpatient Clinic
- Age >18 years
- Personality disorder(s) considered to be primary diagnosis/diagnoses
Inclusion Criteria exclusive to the trial:
- A minimum of four DSM-5 criteria for borderline personality disorder
- Written informed consent
Exclusion Criteria exclusive to the Outpatient Clinic:
- Possibility of a learning disability (IQ<75)
- A diagnosis of schizotypal personality disorder or antisocial personality disorder
- Presence of a comorbid psychiatric disorder that requires specialist treatment elsewhere
- Current (past 2 months) substance dependance including alcohol
- Concurrent psychotherapeutic treatment outside the clinic
Exclusion Criteria exclusive to the trial:
- Lack of informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Short-term MBT
The experimental group is short-term mentalization-based therapy.
The treatment program includes 20 weeks of mentalization-based group therapy with conjoined individual therapy every second week.
The program also includes psychoeducation and individual caseformulations.
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Short-term mentalization-based therapy
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Active Comparator: Long-term MBT
The control group is long-term mentalization-based therapy.
The treatment program includes 14 months of weekly mentalization-based group therapy with combined individual therapy every second week.
The program also includes psychoeducation and individual caseformulations.
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Long-term mentalization-based therapy
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in severity of borderline personality disorder assessed with the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) interview
Time Frame: Assessed at baseline, and at 8, 16 and 24 months post-randomization
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ZAN-BPD is an investigator-administered interview assessing change in severity of borderline personality disorder over time.
Each of the nine DSM-5 criteria for borderline personality disorder are rated on a scale from 0-4, where 4 is the most severe, yielding a total score from 0-36.
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Assessed at baseline, and at 8, 16 and 24 months post-randomization
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in functional impairmment assessed with the Work and Social Adjustment Scale (WSAS)
Time Frame: Assessed at baseline, and at 8, 16 and 24 months post-randomization
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WSAS is a 5-item questionnaire assessing change in functional impairment.
Each item is rated on a scale from 0-8, where 0 is no impairment and 8 is severe impairment, yielding a total score between 0-40.
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Assessed at baseline, and at 8, 16 and 24 months post-randomization
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Change in quality of life assessed with the Short-Form Health Survey 36 (SF-36)
Time Frame: Assessed at baseline, and at 8, 16 and 24 months post-randomization
|
SF-36 is a questionnaire assessing change in self-reported quality of life over time.
The instrument measures eight health dimensions: physical function (PF), role physical (RF), bodily pain (BP), social function (SF) role emotional (RE), general health (GH), vitality (VT) and mental health (MH).
The questions related to each dimension are scored on a scale from 0 (worst score) to 100 (best score).
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Assessed at baseline, and at 8, 16 and 24 months post-randomization
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Change in global functioning assessed with the Global Assessment of Functioning (GAF)
Time Frame: Assessed at baseline, and at 8, 16 and 24 months post-randomization
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GAF is an investigator-administered rating of change in global functioning over time.
Global funtioning is rated on a scale from 0-100 for both symptomatic and functional impairment, yielding two total scores from 0-100, where 100 is no impaitment and 0 is severe impairment.
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Assessed at baseline, and at 8, 16 and 24 months post-randomization
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Change in amount of self-harm incidents
Time Frame: Assessed at baseline, and at 8, 16 and 24 months post-randomization
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Proportion of participants with severe self-harm defined as deliberate acts of self-harm resulting in visible tissue damage - data will be collected as both dichotomous data and count data.
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Assessed at baseline, and at 8, 16 and 24 months post-randomization
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in psychiatric symptom distress assessed with the Symptom Checklist 90 (SCL-90)
Time Frame: Assessed at baseline, and at 8, 16 and 24 months post-randomization
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SCL-90 is a questionnaire assessing change in psychiatric symptom distress over time.
All 90 items are rated on a scale from 0-4.
The total score is divided by number of items, yielding a total score on the Global Severity Index ranging from 0 to 4, where 4 is the most severe.
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Assessed at baseline, and at 8, 16 and 24 months post-randomization
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Collaborators and Investigators
Collaborators
Investigators
- Study Director: Sebastian Simonsen, PhD, Sponsor-Investigator
Publications and helpful links
General Publications
- Gibbon S, Khalifa NR, Cheung NH, Vollm BA, McCarthy L. Psychological interventions for antisocial personality disorder. Cochrane Database Syst Rev. 2020 Sep 3;9(9):CD007668. doi: 10.1002/14651858.CD007668.pub3.
- Storebo OJ, Stoffers-Winterling JM, Vollm BA, Kongerslev MT, Mattivi JT, Jorgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020 May 4;5(5):CD012955. doi: 10.1002/14651858.CD012955.pub2.
- Juul S, Lunn S, Poulsen S, Sorensen P, Salimi M, Jakobsen JC, Bateman A, Simonsen S. Short-term versus long-term mentalization-based therapy for outpatients with subthreshold or diagnosed borderline personality disorder: a protocol for a randomized clinical trial. Trials. 2019 Apr 5;20(1):196. doi: 10.1186/s13063-019-3306-7.
- Juul S, Simonsen S, Poulsen S, Lunn S, Sorensen P, Bateman A, Jakobsen JC. Detailed statistical analysis plan for the short-term versus long-term mentalisation-based therapy for outpatients with subthreshold or diagnosed borderline personality disorder randomised clinical trial (MBT-RCT). Trials. 2021 Jul 28;22(1):497. doi: 10.1186/s13063-021-05450-y.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-18023136
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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