Cognitive therapy v. usual treatment for borderline personality disorder: prospective 6-year follow-up

Davidson, K.M., Tyrer, P., Norrie, J., Palmer, S.J. and Tyrer, H. (2010) Cognitive therapy v. usual treatment for borderline personality disorder: prospective 6-year follow-up. British Journal of Psychiatry, 197(6), pp. 456-462. (doi: 10.1192/bjp.bp.109.074286)

Abstract

Background: Longer-term follow-up of patients with borderline personality disorder have found favourable clinical outcomes, with long-term reduction in symptoms and diagnosis. Aims: We examined the 6-year outcome of patients with borderline personality disorder who were randomised to 1 year of cognitive–behavioural therapy for personality disorders (CBT–PD) or treatment as usual (TAU) in the BOSCOT trial, in three centres across the UK (trial registration: ISRCTN86177428). Method: In total, 106 participants met criteria for borderline personality disorder in the original trial. Patients were interviewed at follow-up by research assistants masked to the patient’s original treatment group, CBT–PD or TAU, using the same measures as in the original randomised trial. Statistical analyses of data for the group as a whole are based on generalised linear models with repeated measures analysis of variance type models to examine group differences. Results: Follow-up data were obtained for 82% of patients at 6 years. Over half the patients meeting criteria for borderline personality disorder at entry into the study no longer did so 6 years later. The gains of CBT–PD over TAU in reduction of suicidal behaviour seen after 1-year follow-up were maintained. Length of hospitalisation and cost of services were lower in the CBT–PD group compared with the TAU group. Conclusions: Although the use of CBT–PD did not demonstrate a statistically significant cost-effective advantage, the findings indicate the potential for continued long-term cost-offsets that accrue following the initial provision of 1 year of CBT–PD. However, the quality of life and affective disturbance remained poor.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Davidson, Professor Kate and Norrie, Prof John
• Authors: Davidson, K.M., Tyrer, P., Norrie, J., Palmer, S.J., and Tyrer, H.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: British Journal of Psychiatry
• ISSN: 0007-1250
• ISSN (Online): 1472-1465