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A randomized controlled trial comparing trauma-focused treatment with and without concurrent personality disorder treatment in patients with posttraumatic stress disorder and comorbid borderline personality disorder

Published online by Cambridge University Press:  27 August 2024

A. Snoek*
Affiliation:
1Sinai Centrum, Arkin, Amstelveen
J. Dekker
Affiliation:
2Arkin
A. Beekman
Affiliation:
3Psychiatry, Amsterdam UMC
A. Beekman
Affiliation:
3Psychiatry, Amsterdam UMC
I. Aarts
Affiliation:
1Sinai Centrum, Arkin, Amstelveen
I. Aarts
Affiliation:
1Sinai Centrum, Arkin, Amstelveen
A. van den End
Affiliation:
4Sinai Centrum, Arkin, Amsterdam, Netherlands
M. Blankers
Affiliation:
2Arkin
C. Vriend
Affiliation:
3Psychiatry, Amsterdam UMC
O. van den Heuvel
Affiliation:
3Psychiatry, Amsterdam UMC
K. Thomaes
Affiliation:
4Sinai Centrum, Arkin, Amsterdam, Netherlands
*
*Corresponding author.

Abstract

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Introduction

Posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD) often co-occur. There is growing motivation among clinicians to offer trauma-focused treatments, such as Eye Movement Desensitization and Reprocessing (EMDR), to patients with PTSD and comorbid BPD. However, a large subgroup of these patients does not sufficiently respond to trauma-focused treatment and is more likely to be excluded or dropout from treatment. Dialectical Behaviour Therapy (DBT) for BPD is well established and although there is some evidence that DBT combined with prolonged exposure is twice as effective in reducing PTSD symptoms than DBT alone, the comparative efficacy of trauma-focused treatment with and without concurrent PD treatment has not been investigated yet.

Objectives

The current study will therefore evaluate the comparative clinical efficacy of EMDR with and without concurrent DBT in patients with PTSD and comorbid BPD.

Methods

Adult patients were randomly assigned to EMDR with (n = 63) or without concurrent DBT (n = 63). A wide range of clinician-administered and self-report assessments were conducted before, during and up to six months after treatment. The longitudinal change in PTSD severity as the primary outcome was measured using multilevel mixed regression in SPSS. The present study is part of the overarching Prediction and Outcome Study in comorbid PTSD and Personality Disorders (PROSPER), which consists of a second RCT comparing trauma-focused treatment with and without concurrent PD treatment in patients with PTSD and cluster C PD.

Results

Results, available in January 2024, will reveal which treatment works best for this difficult-to-treat group of patients.

Conclusions

This is the first study to compare the clinical efficacy of EMDR with and without concurrent DBT in patients with PTSD and comorbid BPD. Results will reveal which treatment works best for this difficult-to-treat group of patients.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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