Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial
Background There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested. Aims To test the feasibility of conducting a randomised controll...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472424008330/type/journal_article |
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| author | Paul Moran Debra Bick Lucy Biddle Belinda Borries Rebecca Kandiyali Farah Mgaieth Vivan Patel Janice Rigby Penny Seume Vaneeta Sadhnani Nadine Smith Michaela Swales Nicholas Turner |
| author_facet | Paul Moran Debra Bick Lucy Biddle Belinda Borries Rebecca Kandiyali Farah Mgaieth Vivan Patel Janice Rigby Penny Seume Vaneeta Sadhnani Nadine Smith Michaela Swales Nicholas Turner |
| author_sort | Paul Moran |
| collection | DOAJ |
| description | Background
There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested.
Aims
To test the feasibility of conducting a randomised controlled trial (RCT) of perinatal ESGs for women and birthing people with BPD.
Method
Two-arm parallel-group feasibility RCT. We recruited people from two centres, aged over 18 years, meeting DSM-5 diagnostic criteria for BPD, who were pregnant or within 12 months of a live birth. Eligible individuals were randomly allocated on a 1:1 ratio to ESGs + treatment as usual (TAU), or to TAU. Outcomes were assessed at 4 months post randomisation.
Results
A total of 100% of the pre-specified sample (n = 48) was recruited over 6 months, and we obtained 4-month outcome data on 92% of randomised participants. In all, 54% of participants allocated to perinatal ESGs attended 75% of the full group treatment (median number of sessions: 9 (interquartile range 6–11). At 4 months, levels of BPD symptoms (adjusted coefficient −2.0, 95% CI −6.2 to 2.1) and emotional distress (−2.4, 95% CI −6.2 to 1.5) were lower among those allocated to perinatal ESGs. The directionality of effect on well-being and social functioning also favoured the intervention. The cost of delivering perinatal ESGs was estimated to be £918 per person.
Conclusions
Perinatal ESGs may represent an effective intervention for perinatal women and birthing people with BPD. Their efficacy should be tested in a fully powered RCT, and this is a feasible undertaking.
Trial registration
ISRCTN80470632.
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| format | Article |
| id | doaj-art-3fc9a2a1228c498ca145cc4179d34407 |
| institution | Kabale University |
| issn | 2056-4724 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-3fc9a2a1228c498ca145cc4179d344072025-01-16T21:47:56ZengCambridge University PressBJPsych Open2056-47242025-01-011110.1192/bjo.2024.833Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trialPaul Moran0https://orcid.org/0000-0002-9257-8699Debra Bick1Lucy Biddle2https://orcid.org/0000-0002-1090-8771Belinda Borries3Rebecca Kandiyali4Farah Mgaieth5Vivan Patel6Janice Rigby7Penny Seume8Vaneeta Sadhnani9Nadine Smith10Michaela Swales11Nicholas Turner12Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, UKWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, UKPopulation Health Sciences Department, Bristol Medical School, University of Bristol, UKSpecialist Community Perinatal Mental Health Service, Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UKCentre for Health Economics, Warwick Clinical Trials Unit, University of Warwick, UKDepartment of Clinical, Educational & Health Psychology, University College London, UKCentre for Health Economics, Warwick Clinical Trials Unit, University of Warwick, UKChanni Kumar Mother and Baby Unit, Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, London, UKCentre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, UKSpecialist Community Perinatal Mental Health Service, Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UKPatient and Public Involvement and Engagement Lead, University of Bristol, UKNorth Wales Clinical Psychology Programme, Bangor University, UKPopulation Health Sciences Department, Bristol Medical School, University of Bristol, UKBackground There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested. Aims To test the feasibility of conducting a randomised controlled trial (RCT) of perinatal ESGs for women and birthing people with BPD. Method Two-arm parallel-group feasibility RCT. We recruited people from two centres, aged over 18 years, meeting DSM-5 diagnostic criteria for BPD, who were pregnant or within 12 months of a live birth. Eligible individuals were randomly allocated on a 1:1 ratio to ESGs + treatment as usual (TAU), or to TAU. Outcomes were assessed at 4 months post randomisation. Results A total of 100% of the pre-specified sample (n = 48) was recruited over 6 months, and we obtained 4-month outcome data on 92% of randomised participants. In all, 54% of participants allocated to perinatal ESGs attended 75% of the full group treatment (median number of sessions: 9 (interquartile range 6–11). At 4 months, levels of BPD symptoms (adjusted coefficient −2.0, 95% CI −6.2 to 2.1) and emotional distress (−2.4, 95% CI −6.2 to 1.5) were lower among those allocated to perinatal ESGs. The directionality of effect on well-being and social functioning also favoured the intervention. The cost of delivering perinatal ESGs was estimated to be £918 per person. Conclusions Perinatal ESGs may represent an effective intervention for perinatal women and birthing people with BPD. Their efficacy should be tested in a fully powered RCT, and this is a feasible undertaking. Trial registration ISRCTN80470632. https://www.cambridge.org/core/product/identifier/S2056472424008330/type/journal_articleBorderline personality disorderperinatal psychiatryrandomised controlled trialpsychological treatmentspersonality disorders |
| spellingShingle | Paul Moran Debra Bick Lucy Biddle Belinda Borries Rebecca Kandiyali Farah Mgaieth Vivan Patel Janice Rigby Penny Seume Vaneeta Sadhnani Nadine Smith Michaela Swales Nicholas Turner Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial BJPsych Open Borderline personality disorder perinatal psychiatry randomised controlled trial psychological treatments personality disorders |
| title | Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial |
| title_full | Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial |
| title_fullStr | Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial |
| title_full_unstemmed | Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial |
| title_short | Perinatal emotional skills groups for women and birthing people with borderline personality disorder: outcomes from a feasibility randomised controlled trial |
| title_sort | perinatal emotional skills groups for women and birthing people with borderline personality disorder outcomes from a feasibility randomised controlled trial |
| topic | Borderline personality disorder perinatal psychiatry randomised controlled trial psychological treatments personality disorders |
| url | https://www.cambridge.org/core/product/identifier/S2056472424008330/type/journal_article |
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