Clinical trial NCT00145678: Psychodynamic Therapy For Co-occurring Borderline Personality Disorder and Alcohol Use Disorder
Official title: Psychodynamic Therapy for Patients With Borderline Personality Disorder and Alcohol Abuse
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Borderline Personality Disorder
Alcohol Use Disorder
Keywords: borderline
alcohol
substance
psychodynamic
psychotherapy
psychoanalytic
Lead sponsor: State University of New York - Upstate Medical University
Sponsor class: OTHER
First posted: 2005-09-05
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of the study is to determine the feasibility and effectiveness of a modified form of psychodynamic psychotherapy for persons suffering from co-occurring borderline personality disorder and an alcohol use disorder.

Detailed description: Borderline Personality Disorder (BPD) is a condition that can cause significant distress and increased risk of death. Many persons with BPD also have an alcohol use disorder (AUD) and there is evidence that this can worsen the outcome and course of both disorders.

A manual-based form of psychodynamic therapy (PT), labeled dynamic deconstructive psychotherapy, has been developed for particularly challenging patients with BPD, especially those with co-occurring substance use disorders. It aims to remediate specific neurocognitive capacities that are responsible for processing of emotional experiences, and so diminishes symptoms of BPD and promotes the development of a coherent and differentiated self-structure. PT has been shown to be helpful for BPD, but has not been tested for people who have BPD with co-occurring substance use disorders.

The proposed study is a randomized controlled trial of PT for persons with BPD and co-occurring AUD that will generate some initial data that can be used to determine the need and feasibility for further outcome studies. Participants are randomized to either a study group receiving weekly PT or to a control group receiving usual care. Enrollment is 15 participants in each group. The study group will receive 12-18 months of PT, with naturalistic follow-up. Outcome measures are administered by a research assistant at enrollment, 3 months, 6 months, 9 months, 12 months, and 30 months.

The investigators anticipate that the PT group will show trends towards better retention in treatment and greater reduction in parasuicides, alcohol misuse, and institutional care. If so, this would have important and positive implications for the large group of patients who suffer from BPD and co-occurring AUD.

Eligibility criteria: Inclusion Criteria:

* Age between 18 and 45 years
* Meets diagnostic criteria for borderline personality disorder and for active alcohol abuse or dependence
* At least average intelligence

Exclusion Criteria:

* Meets diagnostic criteria for schizophrenia, or schizoaffective disorder

Primary outcomes:
measure: episodes of parasuicide, alcohol intoxication, institutional care
timeFrame: 12 months
Secondary outcomes:
measure: depression, dissociation, core symptoms of borderline pd, perceived social support
timeFrame: 12 months
Other outcomes:
Locations:
city: Syracuse
country: United States
facility: SUNY Upstate Medical University, University Hospital
state: New York
Study officials:
affiliation: State University of New York - Upstate Medical University
name: Robert J. Gregory, M.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Gregory RJ. Thematic stages of recovery in the treatment of borderline personality disorder. Am J Psychother. 2004;58(3):335-48. doi: 10.1176/appi.psychotherapy.2004.58.3.335.
citation: Gregory RJ. Borderline attributions. Am J Psychother. 2007;61(2):131-47. doi: 10.1176/appi.psychotherapy.2007.61.2.131.
citation: Gregory RJ. The deconstructive experience. Am J Psychother. 2005;59(4):295-305. doi: 10.1176/appi.psychotherapy.2005.59.4.295.
citation: Storebo OJ, Stoffers-Winterling JM, Vollm BA, Kongerslev MT, Mattivi JT, Jorgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020 May 4;5(5):CD012955. doi: 10.1002/14651858.CD012955.pub2.