Mentalization-based Treatment Versus Bona-fide Treatment for Patients With Borderline Personality Disorder in Germany

NCT ID: NCT06018272

Last Updated: 2024-05-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

304 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-28

Study Completion Date

2028-03-31

Brief Summary

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Background: Borderline Personality Disorder (BPD) is a serious mental disorder. Mentalization-based treatment (MBT) is one evidence-based treatment for individuals with BPD. Specifically, MBT has been highlighted for its effectiveness in reduction of suicidal and non-suicidal self-injury (NSSI). Yet, randomized-controlled trials (RCT) on MBT in outpatient settings compared with bona fide treatment (BFT) are still scarce and none has been conducted in Germany. The primary objective of this RCT is to investigate whether outpatient MBT is more effective in the reduction of crisis events (incidences of NSSI and suicide attempts) compared with BFT (namely psychodynamic or cognitive-behavioural psychotherapy) in Germany. Secondary, MBT's efficacy will be investigated with regard to cost-effectiveness, general and interpersonal functioning, BPD and general symptom severity, social adjustment, quality of life, reduction in psychotropic medication and therapy retention. Additionally, moderator as well as common and treatment specific mediator variables will be investigated.

Study Design/ Study Population/ Methods: Across 5 study sites in Germany, 304 individuals of all genders from age 18 to 65 with a BPD diagnosis and NSSI or suicide attempts in the past will be asked to participate in the study for two years. In the first year, patients will receive either MBT or BFT (psychodynamic or cognitive behavioural psychotherapy) and will take part in continuous scientific assessments. Scientific assessments will continue after therapy completion up to a 12-moth follow up. As primary outcome, crisis events will be assessed via ecological momentary assessment (EMA) four times a week once per month during the first year and once every three months in the second year. Number of crisis events up to 2 years post randomization will be compared between treatment arms using a log-linear regression model following an intention-to-treat approach. Secondary outcomes, such as borderline and general symptom severity, will be assessed at several timepoints. A within-trial cost-effectiveness analysis (CEA) will be conducted with a societal perspective.

Clinical Trial Rationale: This study investigates efficacy of MBT as BPD specific treatment in an outpatient setting compared with BFT in Germany. Results of this study can address a treatment gap in the German healthcare system, and inform about health economic aspects of BPD treatment as well as mechanisms of psychotherapeutic change.

Detailed Description

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Conditions

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Borderline Personality Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Mentalization-Based Treatment (MBT)

Group Type EXPERIMENTAL

Mentalization-Based Treatment (MBT)

Intervention Type BEHAVIORAL

Patients in MBT will receive a maximum of 58 sessions in total. Of those, 30 are weekly individual sessions. 28 sessions are weekly group sessions conducted by two therapists, and consisting of 8 introductory sessions of group psychoeducation followed by 20 group therapy sessions. The duration of MBT is 12 months. MBT is manualized and relies on validating the emotional experience of patients that aims to promote mentalizing. The proposed mechanism of change in MBT is to stabilize mentalizing in certain focus areas in order to create a psychic buffer between affect and behaviour to foster affect regulation, reduce impulsivity and promote functional supportive relationships.

Bona-Fide Treatment in Germany (BFT)

Group Type ACTIVE_COMPARATOR

Bona-Fide Treatment in Germany (BFT)

Intervention Type BEHAVIORAL

Patients in BFT will receive one to two weekly sessions of Bona-Fide-Treatment (Psychodynamic Therapy, PT, or Cognitive Behavioural Therapy, CBT) conducted by community experts delivered as short-term psychotherapy (\<24 sessions) or long-term psychotherapy (\>24 sessions). BFT can be delivered as individual, group or a combination of individual and group treatment as stated in the German psychotherapy regulations.

Interventions

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Mentalization-Based Treatment (MBT)

Patients in MBT will receive a maximum of 58 sessions in total. Of those, 30 are weekly individual sessions. 28 sessions are weekly group sessions conducted by two therapists, and consisting of 8 introductory sessions of group psychoeducation followed by 20 group therapy sessions. The duration of MBT is 12 months. MBT is manualized and relies on validating the emotional experience of patients that aims to promote mentalizing. The proposed mechanism of change in MBT is to stabilize mentalizing in certain focus areas in order to create a psychic buffer between affect and behaviour to foster affect regulation, reduce impulsivity and promote functional supportive relationships.

Intervention Type BEHAVIORAL

Bona-Fide Treatment in Germany (BFT)

Patients in BFT will receive one to two weekly sessions of Bona-Fide-Treatment (Psychodynamic Therapy, PT, or Cognitive Behavioural Therapy, CBT) conducted by community experts delivered as short-term psychotherapy (\<24 sessions) or long-term psychotherapy (\>24 sessions). BFT can be delivered as individual, group or a combination of individual and group treatment as stated in the German psychotherapy regulations.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Borderline Personality Disorder
* non-suicidal self injury or suicide attempts in the past two years as indicated by the IPDE item "repeated suicidal behaviours, gestures, threats or self-harm", one of which has occurred in the past six months

Exclusion Criteria

* acute substance use disorder (exception: cannabis dependency)
* diagnosis of schizophrenia or schizotypal personality disorder
* bipolar I disorder (DSM-5)
* cognitive impairment (IQ\<80) or evidence of organic brain disorder
* BMI\<16.5
* serious medical condition that will require hospitalization within the next year (e.g. cancer)
* no sufficient German language abilities
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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German Research Foundation

OTHER

Sponsor Role collaborator

University Düsseldorf

OTHER

Sponsor Role collaborator

Jena University Hospital

OTHER

Sponsor Role collaborator

Universitätsklinikum Ulm

UNKNOWN

Sponsor Role collaborator

Psychologische Hochschule Berlin

UNKNOWN

Sponsor Role collaborator

Heidelberg University

OTHER

Sponsor Role lead

Responsible Party

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Svenja Taubner

Prof. Dr. phil. Svenja Taubner

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Svenja Taubner

Role: PRINCIPAL_INVESTIGATOR

University Heidelberg

Locations

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Psychologische Hochschule Berlin

Berlin, , Germany

Site Status RECRUITING

Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf

Düsseldorf, , Germany

Site Status NOT_YET_RECRUITING

Heidelberg University

Heidelberg, , Germany

Site Status RECRUITING

Institute for Psychosocial Medicine, Psychotherapy and Psychooncology

Jena, , Germany

Site Status NOT_YET_RECRUITING

Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm

Ulm, , Germany

Site Status NOT_YET_RECRUITING

Countries

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Germany

Central Contacts

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Svenja Taubner, Prof.

Role: CONTACT

+496221564701

Sophie Hauschild, Dr.

Role: CONTACT

Facility Contacts

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Timo Storck, Prof.

Role: primary

Anna-Maria Weiland, M. Sc.

Role: backup

Ulrike Dinger-Ehrenthal, Prof.

Role: primary

Jörg Rademacher, PD

Role: backup

Svenja Taubner, Prof.

Role: primary

Sophie Hauschild, Dr.

Role: backup

Bernhard Strauss, Prof.

Role: primary

Alisa Harthaus, M. Sc.

Role: backup

Volkert Jana, Prof.

Role: primary

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Other Identifiers

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500412881

Identifier Type: -

Identifier Source: org_study_id

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