Reasons for premature termination of dialectical behavior therapy for inpatients with borderline personality disorder
Section snippets
Participants
The participants were admitted consecutively to an inpatient unit of psychiatry and psychotherapy from September 2001 to February 2012. As the Berlin area has a well-developed network of outpatient DBT facilities (www.borderline-netzwerk-berlin.de), only those BPD patients who could not be integrated into an outpatient setting due to severity of illness (i.e., severity of BPD symptoms, comorbidity, low social functioning) were admitted for inpatient DBT. The only exclusion criteria were: a) age
Sample description
Table 1 shows the socio-demographic data and clinical characteristics. The analysis included N = 541 BPD patients, of whom n = 489 were women (90.4%). All participants were Caucasian. Treatment was terminated before day 84 by 176 patients (32.5%). The treatment length for those who terminated treatment prematurely was, on average, 40 days (SD = 21.35). One-hundred participants dropped out and 76 were expelled.
For the total sample, the mean age lay at 29 years (SD = 8.237). Approximately 25.5%
Discussion
Considering different definitions of dropout and varying treatment lengths, the premature termination rate of 32.5% in the present study was lower compared to the median rate of 37% that was reported in a narrative review with regard to non-completion in personality disorder-specific treatments (McMurran et al., 2010). Moreover, the rate was comparable to the non-completion rate of 32% in the Rüsch et al. (2008) study, which also analyzed a 3-month DBT inpatient treatment. The risk of dropout
Acknowledgments
We would like to thank the following colleagues for their support: Carolin Schneider, BSc., and Melanie Stich, M.FA, outpatient clinic of the Technical University Brunswick, who extracted the data and reasons of premature termination; and Anke Banzhaf, Ph.D., Behnoush Behnia, M.D., Katrin Janke, Dipl.-Psych., Carla Palafox, Dipl.-Psych., Dimitris Repantis, M.D., and Sandra Strunz, Dipl.-Psych., all of whom were therapists at the Department of Psychiatry, Charité – Universitätsmedizin Berlin.
References (34)
- et al.
Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial
Behaviour Research and Therapy
(2004) - et al.
Effectiveness, response and dropout of dialectical behavior therapy for borderline personality disorder in an inpatient setting
Behavior Research and Therapy
(2013) - et al.
Effectiveness of dialectical behaviour therapy for borderline personality disorder in an inpatient setting
Behaviour Research and Therapy
(2006) - et al.
Dialectical behavior therapy and an added cognitive behavioural treatment module for eating disorders in women with borderline personality disorder and anorexia nervosa or bulimia nervosa who failed to respond to previous treatments. An open trial with a 15-months follow-up
Journal of Behavior Therapy and Experimental Psychiatry
(2010) - et al.
Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder
Drug and Alcohol Dependence
(2002) - et al.
Predicting outcome for borderline personality disorder
Comprehensive Psychiatry
(1990) - et al.
DBT with an inpatient forensic population: the CMHIP Forensic Model
Cognitive and Behavioral Practice
(2000) - et al.
Non-completion of personality disorder treatments: a systematic review of correlates, consequences, and interventions
Clinical Psychological Review
(2010) - et al.
Predictors of dropout from inpatient dialectical behavior therapy among women with borderline personality disorder
Journal of Behavior Therapy and Experimental Psychiatry
(2008) Psychiatric diagnosis: are clinicians still necessary?
Comprehensive Psychiatry
(1983)