Cognitive Rehabilitation Versus Psychoeducation in Psychosocial Functioning of Borderline Personality Disorder
Condition: Neuropsychology
MeSH terms: Personality Disorders; Borderline Personality Disorder
Study type: Interventional

Summary: 
      Study design was a multicenter, randomized, rater-blind clinical trial. There were
      two-parallel arms (1:1) to evaluate functional, clinical and cognitive efficacy of a specific
      cognitive rehabilitation group intervention (CR) compared with a psychoeducational group
      intervention (PE) in subjects with Borderline Personality Disorder (BPD).
    

Detailed description: 
      To ensure the reliability among centers regarding the evaluation and the treatment fidelity,
      two meetings were organized before the start of the study to train therapists in the
      evaluations and interventions.

      Clinical and neuropsychological evaluations before interventions were administered in
      different days since they lasted in general more than one hour each one and the effect of
      fatigue or boredom might affect the results. Clinical interviews were performed by
      experienced psychiatrists and psychologists during 3 months to ensure the follow-up of all
      participants prospectively. The following sociodemographic and clinical variables were
      collected: age at recruitment, gender, education level, occupational status, and
      pharmacological treatment. All participants were then randomized to receive CR or PE in a 1:1
      ratio stratified by center, age, and education level. Randomization was accomplished with the
      use of computer-generated sequence.

      During the study, subjects did not receive any other individual or group psychotherapy. All
      patients continued pharmacological treatment if it had been initiated prior to inclusion.
      Type and doses of medication could not be modified during the study period. Both
      interventions were applied in a group format and were conducted by two psychologists with
      experience in managing patients with BPD. Subjects were instructed not to disclose any
      information about the intervention to maintain blind conditions. Participants were evaluated
      at baseline, after completion of the intervention, and six months after the end of the
      interventions.

      The study was conducted in accordance with the ethical principles of the Declaration of
      Helsinki and the approval of the Ethical Committee for this study was obtained. All subjects
      received extensive information about the study and provided written informed consent before
      they were enrolled in the study.
    

Intervention name(s): cognitive remediation; Psychoeducation
Intervention type(s): Other; Other
Intervention description(s): Cognitive Rehabilitation (CR). Consisted on group sessions (5 individuals per group) of 120-minutes, twice a week during a total period of 16 weeks (32 sessions). The exercises addressed neurocognitive issues related to sustained attention, processing speed, memory and executive functioning. The whole program aimed at getting new strategies to improve functional adaptation, thus tasks were carried out in the clinical setting and at home. Some homework tasks were based on their daily life difficulties and problems. The main objective of this program was the generalization of rehabilitated cognitive functions to daily life activities. Most of the techniques were based on a previous program for bipolar disorder.; Psychoeducation (PE). The psychoeducation intervention consisted of 16 weekly group sessions of 5 individuals of 120 minutes each (16 sessions). This therapy aimed at improving illness' consciousness , interpersonal abilities, family balance, therapeutical adherence, emotional management in frustrating situations, problems resolutions, and lifestyle regularity. On this intervention, no homework tasks were required. This intervention was based on the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program therapy.
Other intervention name(s): Cognitive rehabilitation; Psychoeducation Programme
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: borderline personality disorder; cognitive rehabilitation; psychoeducation; psychosocial functioning