Ioannis Malogiannis, Lida Anagnostaki, Maria Aspradaki, Panagiotis Aristotelidis, Katerina Karambela, Maria Amperiadou, Vasiliki Efthymiou, Phaithra Kriezi, Ioanna Theodoridou, Pentagiotissa Stefanatou, George Konstantakopoulos, Kyriakos Souliotis, Lily E Peppou, Eleni Giannoulis
{"title":"边缘型人格障碍雅典研究：对边缘型人格障碍患者的公共、心理动力学、阶梯式护理服务评估的准实验实用试验。","authors":"Ioannis Malogiannis, Lida Anagnostaki, Maria Aspradaki, Panagiotis Aristotelidis, Katerina Karambela, Maria Amperiadou, Vasiliki Efthymiou, Phaithra Kriezi, Ioanna Theodoridou, Pentagiotissa Stefanatou, George Konstantakopoulos, Kyriakos Souliotis, Lily E Peppou, Eleni Giannoulis","doi":"10.3389/fpsyt.2025.1493265","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Borderline personality disorder (BPD) is a common mental disorder that severely impairs patients' psychosocial functioning and quality of life and results in prolonged use of health services. Although psychotherapy is recommended as the most effective treatment for patients with BPD, their complex emotional needs can be met in everyday clinical practice by developing integrative, holistic, personalized mental health services tailored to their needs.</p><p><strong>Aim and hypothesis: </strong>The aim of our study was to evaluate the effectiveness of a specialized psychodynamic stepped-care service for BPD patients. Our hypothesis is that patients receiving this specialized health-care service will show greater improvement in clinical, functional and quality of life than patients receiving a treatment as usual (TAU) service. In addition, specialized health-care services will prove to be more cost effective.</p><p><strong>Method and design: </strong>A quasi-experimental clinical trial will be conducted. The study is designed to include 212 BPD patients who will be non-randomly assigned to specialized health care services and to two TAU centers. Patients will be recruited at each site following the routine clinical pathways of referral at each center. The primary outcome measures are BPD severity, suicide attempts and hospital admissions. The secondary outcome measures will include measures of general psychopathology, psychosocial functioning, quality of life and retention in treatment. In addition. An economic evaluation from a societal perspective will be conducted.</p><p><strong>Discussion: </strong>The development of complex individualized stepped-whole care public interventions for BPD patients requires extended research in everyday clinical practice conditions. In this study, we describe the design and implementation of a pragmatic trial to evaluate this type of health service for BPD patients, and we discuss the strengths as well as the problems and how these can be mitigated.</p><p><strong>Trial registration: </strong>Clinical Trials gov.: ClinicalTrials.gov ID: NCT06392139 (Protocol ID No. 404/06-07-202).</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1493265"},"PeriodicalIF":3.2000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259668/pdf/","citationCount":"0","resultStr":"{\"title\":\"Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients.\",\"authors\":\"Ioannis Malogiannis, Lida Anagnostaki, Maria Aspradaki, Panagiotis Aristotelidis, Katerina Karambela, Maria Amperiadou, Vasiliki Efthymiou, Phaithra Kriezi, Ioanna Theodoridou, Pentagiotissa Stefanatou, George Konstantakopoulos, Kyriakos Souliotis, Lily E Peppou, Eleni Giannoulis\",\"doi\":\"10.3389/fpsyt.2025.1493265\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Borderline personality disorder (BPD) is a common mental disorder that severely impairs patients' psychosocial functioning and quality of life and results in prolonged use of health services. Although psychotherapy is recommended as the most effective treatment for patients with BPD, their complex emotional needs can be met in everyday clinical practice by developing integrative, holistic, personalized mental health services tailored to their needs.</p><p><strong>Aim and hypothesis: </strong>The aim of our study was to evaluate the effectiveness of a specialized psychodynamic stepped-care service for BPD patients. Our hypothesis is that patients receiving this specialized health-care service will show greater improvement in clinical, functional and quality of life than patients receiving a treatment as usual (TAU) service. In addition, specialized health-care services will prove to be more cost effective.</p><p><strong>Method and design: </strong>A quasi-experimental clinical trial will be conducted. The study is designed to include 212 BPD patients who will be non-randomly assigned to specialized health care services and to two TAU centers. Patients will be recruited at each site following the routine clinical pathways of referral at each center. The primary outcome measures are BPD severity, suicide attempts and hospital admissions. The secondary outcome measures will include measures of general psychopathology, psychosocial functioning, quality of life and retention in treatment. In addition. An economic evaluation from a societal perspective will be conducted.</p><p><strong>Discussion: </strong>The development of complex individualized stepped-whole care public interventions for BPD patients requires extended research in everyday clinical practice conditions. In this study, we describe the design and implementation of a pragmatic trial to evaluate this type of health service for BPD patients, and we discuss the strengths as well as the problems and how these can be mitigated.</p><p><strong>Trial registration: </strong>Clinical Trials gov.: ClinicalTrials.gov ID: NCT06392139 (Protocol ID No. 404/06-07-202).</p>\",\"PeriodicalId\":12605,\"journal\":{\"name\":\"Frontiers in Psychiatry\",\"volume\":\"16 \",\"pages\":\"1493265\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259668/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fpsyt.2025.1493265\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fpsyt.2025.1493265","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients.
Background: Borderline personality disorder (BPD) is a common mental disorder that severely impairs patients' psychosocial functioning and quality of life and results in prolonged use of health services. Although psychotherapy is recommended as the most effective treatment for patients with BPD, their complex emotional needs can be met in everyday clinical practice by developing integrative, holistic, personalized mental health services tailored to their needs.
Aim and hypothesis: The aim of our study was to evaluate the effectiveness of a specialized psychodynamic stepped-care service for BPD patients. Our hypothesis is that patients receiving this specialized health-care service will show greater improvement in clinical, functional and quality of life than patients receiving a treatment as usual (TAU) service. In addition, specialized health-care services will prove to be more cost effective.
Method and design: A quasi-experimental clinical trial will be conducted. The study is designed to include 212 BPD patients who will be non-randomly assigned to specialized health care services and to two TAU centers. Patients will be recruited at each site following the routine clinical pathways of referral at each center. The primary outcome measures are BPD severity, suicide attempts and hospital admissions. The secondary outcome measures will include measures of general psychopathology, psychosocial functioning, quality of life and retention in treatment. In addition. An economic evaluation from a societal perspective will be conducted.
Discussion: The development of complex individualized stepped-whole care public interventions for BPD patients requires extended research in everyday clinical practice conditions. In this study, we describe the design and implementation of a pragmatic trial to evaluate this type of health service for BPD patients, and we discuss the strengths as well as the problems and how these can be mitigated.
期刊介绍：
Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.
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