Psychodynamic Therapy For Co-occurring Borderline Personality Disorder and Alcohol Use Disorder

State University of New York - Upstate Medical University

Status and phase: Completed; Phase 2

Conditions: Borderline Personality Disorder; Alcohol Use Disorder

Treatments: Behavioral: Optimized Community Care; Behavioral: Psychodynamic Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT00145678

130230-44

SUNY UMU IRB 4968

Details and patient eligibility

About

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.

Full 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.

Enrollment: 30 patients

Sex: All

Ages: 18 to 45 years old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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30 participants in 2 patient groups

dynamic deconstructive psychotherapy

Experimental group

Description:

weekly individual psychotherapy of 50 minute duration lasting 12-18 months

Treatment:

Behavioral: Psychodynamic Therapy

optimized community care

Active Comparator group

Description:

eclectic weekly individual and group psychotherapy, as well as drug and alcohol rehabilitation

Treatment:

Behavioral: Optimized Community Care