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Efficacy and cost-effectiveness of an experimental short-term inpatient Dialectical Behavior Therapy ( DBT ) program : study protocol for a randomized controlled trial . BACKGROUND Borderline Personality Disorder ( BPD ) is a serious psychiatric condition associated with substantial mortality , burden and public health costs . DBT is the treatment model with the largest number of published research articles showing effectiveness . However , some patients are not sufficiently engaged in outpatient treatment while presenting severe parasuicidal behavior , making hospitalization necessary . The Center for Personality Disorders Jelgersma developed an intensive 12-week inpatient DBT program that ( i ) rapidly reduces core borderline symptoms like suicidal behavior , ( ii ) minimizes the negative effects of an inpatient setting , and ( iii ) enhances compliance with outpatient treatment . We evaluate the ( cost- ) effectiveness of this experimental program . METHODS/DESIGN Seventy patients , aged 18 to 45 years with a primary diagnosis of BPD , showing a chronic pattern of parasuicidal gestures and/or reporting high degrees of severity of other borderline symptoms , are randomly allocated to the control and intervention groups . Subjects in the control group receive standard outpatient DBT , provided in one of three regular mental health settings in GGZ Rivierduinen . Subjects in the intervention group receive 12 weeks of intensified inpatient DBT plus six months of standard DBT , provided in the Center for Personality Disorders Jelgersma . The primary outcome is the number of suicide attempts/self-harming acts . Secondary outcomes are severity of other borderline complaints , quality of life , general psychopathological symptoms and health care utilization and productivity costs . Data are gathered using a prospective , two ( group : intervention and control ) by five ( time of measurement ) repeated measures factorial design.Participants will complete three-monthly outcome assessments in the course of therapy : at baseline , and 12 , 24 , 36 and 52 weeks after the start of the treatment . The period of recruitment started in March 2012 and the study will end in December 2014 . DISCUSSION Highly suicidal outpatient patients can pose a dilemma for mental health care professionals . Although hospitalization seems inevitable under some circumstances , it has proven to be harmful in its own right . This paper outlines the background and methods of a randomized trial evaluating the possible surplus value of a short-term inpatient DBT program .
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Intervention_Educational
inpatient Dialectical Behavior Therapy ( DBT )
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Outcome_Other
Efficacy and cost-effectiveness
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Outcome_Other
( cost- ) effectiveness
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Outcome_Mental
the number of suicide attempts/self-harming acts
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Outcome_Mental
severity of other borderline complaints , quality of life , general psychopathological symptoms
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Outcome_Other
health care utilization and productivity costs
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Participant_Condition
Borderline Personality Disorder ( BPD )
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Participant_Age
aged 18 to 45 years
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Participant_Condition
GGZ Rivierduinen
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Participant_Condition
Personality Disorders Jelgersma
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Participant_Condition
Highly suicidal outpatient