Mentalization - Based Treatment: Adolescents With Co-morbid Depression and Personality Disorder

Study Overview
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Brief Summary
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Mentalisation based treatment (MBT) for young people with co-morbid depression and emerging personality disorder will be more effective in a day/inpatient setting than treatment as usual.

Detailed Description
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Systematic literature review on outcomes with young people with depression and emerging personality disorder showed clear evidence that this group of young people are severely hampered and adult outcomes are strongly linked to both adult PD as well as adult psychiatric disturbance and lower levels of adult functioning. (Crawford et al, 2008; Kasen et al, 1999; Kasen et al, 2007; Lewinsohn et al, 1999) This argues very clearly for the need to diagnose young people presenting with co-morbid depression and emerging personality disorder in order to intervene and help these young people's struggles as it will prevent poor prognostic adult outcomes. There were no treatment programs that specifically focussed on the treatment of this co-morbid group in the literature. Several studies focussed on the treatment of depression alone and only one RCT focussed on the treatment of adolescent personality disorder (Chanen et al, 2007). In adult studies mentalization-based treatment programs were found to be effective ( as well as cost effective) in a day hospital setting for adults with personality disorder and depression (Bateman, et al, 2007) This study aims to conduct a control trial to test whether MBT will be more effective than TAU in this group. All cases will be tested on admission, at discharge and followed up at 2 years post discharge.

Official Title
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Mentalization - Based Treatment for Young People Presenting With Co-morbid Depression and Symptoms of Emerging Personality Disorder: Prospective Controlled Trial.

Conditions
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Depression, Personality Disorder

Intervention / Treatment
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* Other: MBT
* Other: treatment as usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all young people who are admitted to Brookside adolescent unit between the ages 12 - 17 presenting with depression and emerging personality disorder will be eligible Exclusion Criteria: Young people with autistic spectrum disorders or severe learning disabilities.

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MBT group<br>mentalization based treatment program | Other: MBT<br>* The intervention consists of twice weekly individual MBT therapy, group therapy with an MBT focus and weekly MBFT, which is MBT for families. The treatment duration will be 6-8 weeks.<br>* Other names: Psychotherapeutic program;|
| Active Comparator: Treatment as usual group<br>treatment as usual group | Other: treatment as usual<br>* less intensive and structured psychotherapeutic program<br>* Other names: Psychotherapeutic program;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Global assessment of functioning | Measures global functioning | 2 years post discharge | 
| Global assessment of functioning | measures level of functioning | within 1 week of admission | 
| global assessment of functioning | measures level of functioning | Average of 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mood and feelings questionnaire | Assesses mood in terms of number of depressive symptoms | 2 years post discharge | 
| Mood and feelings questionnaire | Assesses mood in terms of number of depressive symptoms | Within 1 week of admission | 
| mood and feelings questionnaire | Assesses mood in terms of number of depressive symptoms | At average of 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adolescents, MBT, depression, emerging personality disorder