Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Changes in Methylation Status of BDNF Gene After Receiving Dialectical Behavior Therapy in Patients With Borderline Personality Disorder
Brief Summary: Borderline personality disorder (BPD) is a chronic and debilitating syndrome associated with considerable morbidity, mortality, and high rates of medical and psychiatric utilization services. Research focusing on finding a biological observable marker for the purpose of monitoring treatment effects has started to draw attention. Recent research has implicated that brain-derived neutrophilic factor (BDNF) might be a natural candidate for a biological correlate of early life stress. The alterations in levels of BDNF or BDNF methylation in BPD patients compared to general population, or pre- and post- psychotherapeutic treatment might indicate the consequence of epigenetic modification associated with stressful experience or suicide, and may later be able to explain the psychopathology or neuro-development of BPD.

Method: The investigators therefore propose this current randomized control trial to test whether epigenetic changes happen during and after DBT treatments, and not TAU. Proportions having suicide or non-suicidal self injurious behaviors will be followed and tested against changes in BDNF methylation levels. Other clinical symptoms will as be assessed, including suicidality, depression, hopelessness, quality of life, disability, service utilization, and function.

In the first to third years of this study, the investigators will aim to recruit 180 study and control subjects, to gather information, to collect biological samples, to give out one-year of psychotherapy per subject, to evaluate results before, during, and after treatment. In addition, the investigators also hope to explore the effects of known or unknown drugs associated with the change of DNA methylation at cell level.

Hypothesis:

Responders of participants who receive DBT will show greater decrease in BDNF methylation levels than patients receiving TAU.


Options:
A: Arm Label: dialectical behavior therapy; Type: EXPERIMENTAL; Interventions: Behavioral: Dialectical behavior therapy | Arm Label: treatment as usual; Type: PLACEBO_COMPARATOR; Interventions: Other: Treatment as Usual: any other drug or psychotherapy offered to participants, except DBT | Arm Label: Receiving no treatment at all; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Dialectical behavior therapy; Assigned to Arm(s): dialectical behavior therapy | Intervention Type: OTHER; Name: Treatment as Usual: any other drug or psychotherapy offered to participants, except DBT; Assigned to Arm(s): treatment as usual
B: Intervention Type: DRUG; Name: Topiramate; Assigned to Arm(s): N/A
C: Arm Label: Inpatient Adaptation of DBT; Type: EXPERIMENTAL; Interventions: Behavioral: Inpatient Adaptation of DBT | Arm Label: Outpatient DBT; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: standard outpatient DBT | Intervention Type: BEHAVIORAL; Name: standard outpatient DBT; Assigned to Arm(s): Outpatient DBT | Intervention Type: BEHAVIORAL; Name: Inpatient Adaptation of DBT; Assigned to Arm(s): Inpatient Adaptation of DBT
D: Arm Label: Dialectical Behavior Therapy Fluoxetine; Type: EXPERIMENTAL; Interventions: Drug: Fluoxetine, Behavioral: Dialectical Behavior Therapy | Arm Label: Dialectical Behavior Therapy placebo; Type: PLACEBO_COMPARATOR; Interventions: Behavioral: Dialectical Behavior Therapy | Arm Label: Supportive therapy Fluoxetine; Type: EXPERIMENTAL; Interventions: Drug: Fluoxetine, Behavioral: Supportive psychotherapy | Arm Label: Supportive therapy placebo; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Supportive psychotherapy | Intervention Type: DRUG; Name: Fluoxetine; Assigned to Arm(s): Dialectical Behavior Therapy Fluoxetine, Supportive therapy Fluoxetine | Intervention Type: BEHAVIORAL; Name: Dialectical Behavior Therapy; Assigned to Arm(s): Dialectical Behavior Therapy Fluoxetine, Dialectical Behavior Therapy placebo | Intervention Type: BEHAVIORAL; Name: Supportive psychotherapy; Assigned to Arm(s): Supportive therapy Fluoxetine, Supportive therapy placebo

Answer: A