Effectiveness of psychotherapy in personality disorders not otherwise specified: A comparison of different treatment modalities

E.K. Horn, A. Bartak, A.M.M.A. Meerman, B.V. Rossum, U.M. Ziegler, M.A.G. Thunissen, M. Soons, H. Andrea, E.F.M. Hamers, P.M.G. Emmelkamp, T. Stijnen, J.J.V. Busschbach, R. Verheul

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective
Although personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy.
Method
A total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups.
Results
All treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished.
Conclusion
Patients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness.
Original languageEnglish
Pages (from-to)426–442
JournalClinical Psychology & Psychotherapy
Volume22
Issue number5
DOIs
Publication statusPublished - 2015

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Cite this

Horn, E. K., Bartak, A., Meerman, A. M. M. A., Rossum, B. V., Ziegler, U. M., Thunissen, M. A. G., ... Verheul, R. (2015). Effectiveness of psychotherapy in personality disorders not otherwise specified: A comparison of different treatment modalities. Clinical Psychology & Psychotherapy, 22(5), 426–442. https://doi.org/10.1002/cpp.1904
Horn, E.K. ; Bartak, A. ; Meerman, A.M.M.A. ; Rossum, B.V. ; Ziegler, U.M. ; Thunissen, M.A.G. ; Soons, M. ; Andrea, H. ; Hamers, E.F.M. ; Emmelkamp, P.M.G. ; Stijnen, T. ; Busschbach, J.J.V. ; Verheul, R. / Effectiveness of psychotherapy in personality disorders not otherwise specified : A comparison of different treatment modalities. In: Clinical Psychology & Psychotherapy. 2015 ; Vol. 22, No. 5. pp. 426–442.
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title = "Effectiveness of psychotherapy in personality disorders not otherwise specified: A comparison of different treatment modalities",
abstract = "ObjectiveAlthough personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy.MethodA total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups.ResultsAll treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished.ConclusionPatients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness.",
author = "E.K. Horn and A. Bartak and A.M.M.A. Meerman and B.V. Rossum and U.M. Ziegler and M.A.G. Thunissen and M. Soons and H. Andrea and E.F.M. Hamers and P.M.G. Emmelkamp and T. Stijnen and J.J.V. Busschbach and R. Verheul",
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Horn, EK, Bartak, A, Meerman, AMMA, Rossum, BV, Ziegler, UM, Thunissen, MAG, Soons, M, Andrea, H, Hamers, EFM, Emmelkamp, PMG, Stijnen, T, Busschbach, JJV & Verheul, R 2015, 'Effectiveness of psychotherapy in personality disorders not otherwise specified: A comparison of different treatment modalities' Clinical Psychology & Psychotherapy, vol. 22, no. 5, pp. 426–442. https://doi.org/10.1002/cpp.1904

Effectiveness of psychotherapy in personality disorders not otherwise specified : A comparison of different treatment modalities. / Horn, E.K.; Bartak, A.; Meerman, A.M.M.A.; Rossum, B.V.; Ziegler, U.M.; Thunissen, M.A.G.; Soons, M.; Andrea, H.; Hamers, E.F.M.; Emmelkamp, P.M.G.; Stijnen, T.; Busschbach, J.J.V.; Verheul, R.

In: Clinical Psychology & Psychotherapy, Vol. 22, No. 5, 2015, p. 426–442.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Effectiveness of psychotherapy in personality disorders not otherwise specified

T2 - A comparison of different treatment modalities

AU - Horn, E.K.

AU - Bartak, A.

AU - Meerman, A.M.M.A.

AU - Rossum, B.V.

AU - Ziegler, U.M.

AU - Thunissen, M.A.G.

AU - Soons, M.

AU - Andrea, H.

AU - Hamers, E.F.M.

AU - Emmelkamp, P.M.G.

AU - Stijnen, T.

AU - Busschbach, J.J.V.

AU - Verheul, R.

PY - 2015

Y1 - 2015

N2 - ObjectiveAlthough personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy.MethodA total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups.ResultsAll treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished.ConclusionPatients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness.

AB - ObjectiveAlthough personality disorder not otherwise specified (PDNOS) is highly prevalent and associated with a high burden of disease, only a few treatment studies in this patient group exist. This study is the first to investigate the effectiveness of different modalities of psychotherapy in patients with PDNOS, i.e., short-term (up to 6 months) and long-term (more than 6 months) outpatient, day hospital, and inpatient psychotherapy.MethodA total of 205 patients with PDNOS were assigned to one of six treatment modalities. Effectiveness was assessed over 60 months after baseline. The primary outcome measure was symptom severity, and the secondary outcome measures included psychosocial functioning and quality of life. The study design was quasi-experimental, and the multiple propensity score was used to control for initial differences between treatment groups.ResultsAll treatment modalities showed positive outcomes, especially in terms of improvements of symptom severity and social role functioning. At 12-month follow-up, after adjustment for initial differences between the treatment groups, short-term outpatient psychotherapy and short-term inpatient psychotherapy showed most improvement and generally outperformed the other modalities concerning symptom severity. At 60 months after baseline, effectiveness remained but observed differences between modalities mostly diminished.ConclusionPatients with PDNOS benefit from psychotherapy both at short-term and long-term follow-up. Short-term outpatient psychotherapy and short-term inpatient psychotherapy seem to be superior to the other treatment modalities at 12-month follow-up. At 60-month follow-up, treatments showed mostly comparable effectiveness.

U2 - 10.1002/cpp.1904

DO - 10.1002/cpp.1904

M3 - Article

VL - 22

SP - 426

EP - 442

JO - Clinical Psychology & Psychotherapy

JF - Clinical Psychology & Psychotherapy

SN - 1063-3995

IS - 5

ER -