Feasibility of standard Dialectical-Behavioral Therapy for Borderline Personality Disorder: a real-world study in Italian outpatient services
Background: Dialectical-Behavioral Therapy (DBT) is an effective multimodal psychotherapeutic intervention for patients with Borderline Personality Disorder (BPD). However, there is limited evidence regarding the feasibility and effectiveness of DBT in Italian outpatient public mental health service...
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| Format: | Article |
| Language: | English |
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University of Messina
2024-12-01
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| Series: | Mediterranean Journal of Clinical Psychology |
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| Online Access: | https://cab.unime.it/journals/index.php/MJCP/article/view/4353 |
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| author | Mauro Scala Sara Longobardi Biancamaria Bortolotti Sara Gibiino Francesca Martino Loredana Lia Marco Menchetti |
| author_facet | Mauro Scala Sara Longobardi Biancamaria Bortolotti Sara Gibiino Francesca Martino Loredana Lia Marco Menchetti |
| author_sort | Mauro Scala |
| collection | DOAJ |
| description | Background: Dialectical-Behavioral Therapy (DBT) is an effective multimodal psychotherapeutic intervention for patients with Borderline Personality Disorder (BPD). However, there is limited evidence regarding the feasibility and effectiveness of DBT in Italian outpatient public mental health services.
Methods: This retrospective, longitudinal observational study presents preliminary data on the feasibility (assessed through patient enrollment compared to initial referrals, dropout, and participation rates) of a one-year standard DBT program implemented in three Community Mental Health Centers in Bologna, Italy, from 2013 to 2020. An additional outcome includes exploring the effectiveness of this intervention, evaluated by comparing the incidence of non-suicidal self-harm behaviors, unplanned outpatient visits, emergency department (AE) admissions, and hospitalizations (frequency and duration) in the year before and after the DBT program. Participants were outpatients aged 18–45 years who met DSM-5 criteria for BPD. Data were analyzed using descriptive statistics, unpaired and paired t-test, Chi-square tests, logistic regression, and McNemar's test.
Results: Of 132 initial referrals, 51 outpatients were enrolled in the standard DBT program, and 37 completed it. The enrollment gap was primarily due to low motivation, negative attitudes toward psychotherapy, and scheduling conflicts with personal, work, or study commitments. High participation among completers (72.5%) and low dropout rate (27.5%) indicate good feasibility of standard DBT. Dropouts were significantly older than completers (35.4 ± 8.2 vs. 29.8 ± 8.0; p = 0.032), with age emerging as a significant predictor of dropout (OR = 1.15; p = 0.039). Regarding effectiveness, significant reductions in self-harm behaviors, unscheduled outpatient visits, and hospitalizations are consistent with prior research findings.
Conclusions: Our findings suggest that standard DBT may be a feasible treatment for outpatient mental health services as part of a stepped-care approach. Furthermore, this study supports the effectiveness of DBT while providing valuable insights into its real-world applicability. |
| format | Article |
| id | doaj-art-2b9e567802ee408887f4f6d1ed442182 |
| institution | DOAJ |
| issn | 2282-1619 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | University of Messina |
| record_format | Article |
| series | Mediterranean Journal of Clinical Psychology |
| spelling | doaj-art-2b9e567802ee408887f4f6d1ed4421822025-08-20T03:11:22ZengUniversity of MessinaMediterranean Journal of Clinical Psychology2282-16192024-12-0112310.13129/2282-1619/mjcp-43533703Feasibility of standard Dialectical-Behavioral Therapy for Borderline Personality Disorder: a real-world study in Italian outpatient servicesMauro Scala0Sara Longobardi1Biancamaria Bortolotti2Sara Gibiino3Francesca Martino4Loredana Lia5Marco Menchetti6<div class="page" title="Page 3"> <div class="section"> <div class="layoutArea"> <div class="column"> <p>Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy; Complutense University of Madrid (UCM), Madrid; Psychiatry Department, Health Research Institute Hospital 12 de Octubre, (imas 12), Madrid</p> </div> </div> </div> </div><p class="CorpoA">Department of Mental Health–Pathological Addictions, Local Health Unit of Bologna</p>Department of Mental Health–Pathological Addictions, Local Health Unit of Bologna<p class="CorpoA">Department of Mental Health–Pathological Addictions, Local Health Unit of Bologna</p>Department of Mental Health–Pathological Addictions, Local Health Unit of BolognaDepartment of Mental Health–Pathological Addictions, Local Health Unit of BolognaDepartment of Biomedical and Neuromotor Sciences (DIBINEM), University of BolognaBackground: Dialectical-Behavioral Therapy (DBT) is an effective multimodal psychotherapeutic intervention for patients with Borderline Personality Disorder (BPD). However, there is limited evidence regarding the feasibility and effectiveness of DBT in Italian outpatient public mental health services. Methods: This retrospective, longitudinal observational study presents preliminary data on the feasibility (assessed through patient enrollment compared to initial referrals, dropout, and participation rates) of a one-year standard DBT program implemented in three Community Mental Health Centers in Bologna, Italy, from 2013 to 2020. An additional outcome includes exploring the effectiveness of this intervention, evaluated by comparing the incidence of non-suicidal self-harm behaviors, unplanned outpatient visits, emergency department (AE) admissions, and hospitalizations (frequency and duration) in the year before and after the DBT program. Participants were outpatients aged 18–45 years who met DSM-5 criteria for BPD. Data were analyzed using descriptive statistics, unpaired and paired t-test, Chi-square tests, logistic regression, and McNemar's test. Results: Of 132 initial referrals, 51 outpatients were enrolled in the standard DBT program, and 37 completed it. The enrollment gap was primarily due to low motivation, negative attitudes toward psychotherapy, and scheduling conflicts with personal, work, or study commitments. High participation among completers (72.5%) and low dropout rate (27.5%) indicate good feasibility of standard DBT. Dropouts were significantly older than completers (35.4 ± 8.2 vs. 29.8 ± 8.0; p = 0.032), with age emerging as a significant predictor of dropout (OR = 1.15; p = 0.039). Regarding effectiveness, significant reductions in self-harm behaviors, unscheduled outpatient visits, and hospitalizations are consistent with prior research findings. Conclusions: Our findings suggest that standard DBT may be a feasible treatment for outpatient mental health services as part of a stepped-care approach. Furthermore, this study supports the effectiveness of DBT while providing valuable insights into its real-world applicability.https://cab.unime.it/journals/index.php/MJCP/article/view/4353borderline personality disorder (bpd)clinical psychologydialectical behavioral therapy (dbt)feasibilityoutpatients mental health services. |
| spellingShingle | Mauro Scala Sara Longobardi Biancamaria Bortolotti Sara Gibiino Francesca Martino Loredana Lia Marco Menchetti Feasibility of standard Dialectical-Behavioral Therapy for Borderline Personality Disorder: a real-world study in Italian outpatient services Mediterranean Journal of Clinical Psychology borderline personality disorder (bpd) clinical psychology dialectical behavioral therapy (dbt) feasibility outpatients mental health services. |
| title | Feasibility of standard Dialectical-Behavioral Therapy for Borderline Personality Disorder: a real-world study in Italian outpatient services |
| title_full | Feasibility of standard Dialectical-Behavioral Therapy for Borderline Personality Disorder: a real-world study in Italian outpatient services |
| title_fullStr | Feasibility of standard Dialectical-Behavioral Therapy for Borderline Personality Disorder: a real-world study in Italian outpatient services |
| title_full_unstemmed | Feasibility of standard Dialectical-Behavioral Therapy for Borderline Personality Disorder: a real-world study in Italian outpatient services |
| title_short | Feasibility of standard Dialectical-Behavioral Therapy for Borderline Personality Disorder: a real-world study in Italian outpatient services |
| title_sort | feasibility of standard dialectical behavioral therapy for borderline personality disorder a real world study in italian outpatient services |
| topic | borderline personality disorder (bpd) clinical psychology dialectical behavioral therapy (dbt) feasibility outpatients mental health services. |
| url | https://cab.unime.it/journals/index.php/MJCP/article/view/4353 |
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