Please select the eligibility criteria that correspond to the clinical trial below.
Title: Efficacy of Dialectical Behavior Therapy in Patient With Self Harming Behavior and Traits Within the Spectrum of Borderline Personality Disorder.
Brief Summary: Purpose: The purpose of this study is to investigate the efficacy of Dialectical Behavior Therapy (DBT) versus CAMS (Collaborative Assessment and Management of Suicidality) -informed supportive psychotherapy on the risk of self-harm acts and suicide attempts in patients with self behavior and personality traits within the spectrum of borderline personality disorder.

Hypothesis: The hypothesis is 16 weeks of treatment with Dialectical Behavior Therapy (DBT) after a defined manual has a higher efficacy than CAMS-informed supportive psychotherapy on self-harm acts, suicide attempts, suicidal ideation, depressive symptoms, impulsiveness and consumption of hospital services in patients with symptoms within the spectrum of borderline personality disorder (BDP).

Method: The investigators will include 160 patients in the randomized trial to investigate whether 16 weeks of DBT-treatment as a higher efficacy than CAMS-informed supportive psychotherapy on the risk of self-harm acts and suicide attempts in patients with self-harm behavior and personality traits within the spectrum of borderline personality disorder. The trial will meet strict criteria for high quality randomized trials, and will hopefully help to establish evidence for the treatment of this patient group at higher risk of later suicide. There will be performed follow up interviews after 16 weeks, 28 weeks and 52 weeks.


Options:
A: Inclusion Criteria:

* ages 13-18
* English speaking adolescent and at least one English speaking parent
* receiving mental health treatment
* living with a parent or guardian willing to participate

Exclusion Criteria:

* Active Alcohol or Marijuana Dependence Diagnosis
* HIV infection
* Pregnant
* Current psychosis
* Cognitively unable to give assent
B: Inclusion Criteria:

* Patient admitted to Massachusetts General Hospital inpatient psychiatric unit
* Age 18 and older
* Able to read/write in English
* SI documented on admission OR admission due to a suicide attempt
* Admission diagnosis of MDD (and current major depressive episode), confirmed using the Mini International Neuropsychiatric Interview (MINI) and inpatient chart review

Exclusion Criteria:

* Psychotic symptoms, as assessed using the MINI and inpatient chart review
* Cognitive disorder, assessed using a six-item cognitive screen developed for research
* Primary admission diagnosis of substance use disorder
C: Inclusion Criteria:

* 18-65 years of age.
* Newly suicide attempt within one month of the inclusion date.
* A minimum of two characteristics in the DSM-IV Borderline Personality Disorder (BPD)
* Informed consent.

Exclusion Criteria:

* Severe depression.
* Bipolar disorder.
* Psychosis within the schizophrenic spectrum.
* Anorexia Nervosa.
* Substance abuse.
* Mental retardation.
* Dementia.
* Lack of informed consent
D: Inclusion Criteria:

* Recent episode of SH (in the past six months, self-reported)
* A score of 14 or greater on the Beck Depression Inventory-II (BDI-II) corresponding to the BDI-II score where 14-19 = mild depression, 20-28 = moderate depression, \>28 = severe depression
* Aged 16 years and over (SH is especially prevalent in adolescents and young adults and often this transitional age is neglected. This study will be offering at least TAU which young people may not otherwise access. To leave 16-18 year olds out of this study may be unethical and guidance from the British Psychological Society states that people aged 16 years and over can give informed consent)
* Help-seeking, defined as attendance at GP practices or self-referral into the trial

Exclusion Criteria:

* Non-English speaking
* Diagnosed with an intellectual disability as determined by review of clinical notes - the therapy has not yet been adapted for working with this population
* Experiencing severe problems with addiction to alcohol or illicit drugs
* Actively suicidal or psychotic and/or severely depressed and unresponsive to treatment as judged by clinical team
* Unable or unwilling to give written informed consent to participate in the study
* Currently receiving talking therapy for SH

Answer: C