Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients
BackgroundBorderline personality disorder (BPD) is a common mental disorder that severely impairs patients’ psychosocial functioning and quality of life and results in prolonged use of health services. Although psychotherapy is recommended as the most effective treatment for patients with BPD, their...
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Frontiers Media S.A.
2025-07-01
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| author | Ioannis Malogiannis Lida Anagnostaki Maria Aspradaki Panagiotis Aristotelidis Katerina Karambela Maria Amperiadou Vasiliki Efthymiou Phaithra Kriezi Ioanna Theodoridou Pentagiotissa Stefanatou Pentagiotissa Stefanatou George Konstantakopoulos George Konstantakopoulos Kyriakos Souliotis Lily E. Peppou Eleni Giannoulis Eleni Giannoulis |
| author_facet | Ioannis Malogiannis Lida Anagnostaki Maria Aspradaki Panagiotis Aristotelidis Katerina Karambela Maria Amperiadou Vasiliki Efthymiou Phaithra Kriezi Ioanna Theodoridou Pentagiotissa Stefanatou Pentagiotissa Stefanatou George Konstantakopoulos George Konstantakopoulos Kyriakos Souliotis Lily E. Peppou Eleni Giannoulis Eleni Giannoulis |
| author_sort | Ioannis Malogiannis |
| collection | DOAJ |
| description | BackgroundBorderline personality disorder (BPD) is a common mental disorder that severely impairs patients’ psychosocial functioning and quality of life and results in prolonged use of health services. Although psychotherapy is recommended as the most effective treatment for patients with BPD, their complex emotional needs can be met in everyday clinical practice by developing integrative, holistic, personalized mental health services tailored to their needs.Aim and hypothesisThe aim of our study was to evaluate the effectiveness of a specialized psychodynamic stepped-care service for BPD patients. Our hypothesis is that patients receiving this specialized health-care service will show greater improvement in clinical, functional and quality of life than patients receiving a treatment as usual (TAU) service. In addition, specialized health-care services will prove to be more cost effective.Method and designA quasi-experimental clinical trial will be conducted. The study is designed to include 212 BPD patients who will be non-randomly assigned to specialized health care services and to two TAU centers. Patients will be recruited at each site following the routine clinical pathways of referral at each center. The primary outcome measures are BPD severity, suicide attempts and hospital admissions. The secondary outcome measures will include measures of general psychopathology, psychosocial functioning, quality of life and retention in treatment. In addition. An economic evaluation from a societal perspective will be conducted.DiscussionThe development of complex individualized stepped-whole care public interventions for BPD patients requires extended research in everyday clinical practice conditions. In this study, we describe the design and implementation of a pragmatic trial to evaluate this type of health service for BPD patients, and we discuss the strengths as well as the problems and how these can be mitigated.Trial registrationClinical Trials gov.: ClinicalTrials.gov ID: NCT06392139 (Protocol ID No. 404/06-07-202). |
| format | Article |
| id | doaj-art-5dd4a9c5a77c4867bc4d7fd65fbda46e |
| institution | Kabale University |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj-art-5dd4a9c5a77c4867bc4d7fd65fbda46e2025-08-20T03:29:57ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-07-011610.3389/fpsyt.2025.14932651493265Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patientsIoannis Malogiannis0Lida Anagnostaki1Maria Aspradaki2Panagiotis Aristotelidis3Katerina Karambela4Maria Amperiadou5Vasiliki Efthymiou6Phaithra Kriezi7Ioanna Theodoridou8Pentagiotissa Stefanatou9Pentagiotissa Stefanatou10George Konstantakopoulos11George Konstantakopoulos12Kyriakos Souliotis13Lily E. Peppou14Eleni Giannoulis15Eleni Giannoulis16Specific Sector of Personality Disorders, First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceDepartment of Early Childhood Education, National and Kapodistrian University of Athens, Athens, GreeceSpecific Sector of Personality Disorders, First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceSecond Department of Psychiatry, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceSpecific Sector of Personality Disorders, First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceSpecific Sector of Personality Disorders, First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceUniversity Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, GreeceDepartment of Psychiatry, Sismanogleion Hospital, Athens, GreeceSecond Department of Psychiatry, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceDepartment of Speech and Language Therapy, University of Peloponese, Kalamata, GreeceFirst Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceFirst Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceResearch Department of Clinical, University College London, Education and Health Psychology, London, United KingdomDepartment of Social and Education Policy, University of Peloponnese, Korinthos, Greece0Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, National and Kapodistrian University of Athens, Athens, GreeceSpecific Sector of Personality Disorders, First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece1Laboratory of Psychometrics and Neuropsychology, First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GreeceBackgroundBorderline personality disorder (BPD) is a common mental disorder that severely impairs patients’ psychosocial functioning and quality of life and results in prolonged use of health services. Although psychotherapy is recommended as the most effective treatment for patients with BPD, their complex emotional needs can be met in everyday clinical practice by developing integrative, holistic, personalized mental health services tailored to their needs.Aim and hypothesisThe aim of our study was to evaluate the effectiveness of a specialized psychodynamic stepped-care service for BPD patients. Our hypothesis is that patients receiving this specialized health-care service will show greater improvement in clinical, functional and quality of life than patients receiving a treatment as usual (TAU) service. In addition, specialized health-care services will prove to be more cost effective.Method and designA quasi-experimental clinical trial will be conducted. The study is designed to include 212 BPD patients who will be non-randomly assigned to specialized health care services and to two TAU centers. Patients will be recruited at each site following the routine clinical pathways of referral at each center. The primary outcome measures are BPD severity, suicide attempts and hospital admissions. The secondary outcome measures will include measures of general psychopathology, psychosocial functioning, quality of life and retention in treatment. In addition. An economic evaluation from a societal perspective will be conducted.DiscussionThe development of complex individualized stepped-whole care public interventions for BPD patients requires extended research in everyday clinical practice conditions. In this study, we describe the design and implementation of a pragmatic trial to evaluate this type of health service for BPD patients, and we discuss the strengths as well as the problems and how these can be mitigated.Trial registrationClinical Trials gov.: ClinicalTrials.gov ID: NCT06392139 (Protocol ID No. 404/06-07-202).https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1493265/fullborderline personality disordernaturalistic designstepped carepsychodynamiceffectivenesscost evaluation |
| spellingShingle | Ioannis Malogiannis Lida Anagnostaki Maria Aspradaki Panagiotis Aristotelidis Katerina Karambela Maria Amperiadou Vasiliki Efthymiou Phaithra Kriezi Ioanna Theodoridou Pentagiotissa Stefanatou Pentagiotissa Stefanatou George Konstantakopoulos George Konstantakopoulos Kyriakos Souliotis Lily E. Peppou Eleni Giannoulis Eleni Giannoulis Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients Frontiers in Psychiatry borderline personality disorder naturalistic design stepped care psychodynamic effectiveness cost evaluation |
| title | Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients |
| title_full | Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients |
| title_fullStr | Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients |
| title_full_unstemmed | Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients |
| title_short | Borderline personality disorder Athens study: a quasi-experimental pragmatic trial for the assessment of a public, psychodynamic, stepped care service for borderline personality disorder patients |
| title_sort | borderline personality disorder athens study a quasi experimental pragmatic trial for the assessment of a public psychodynamic stepped care service for borderline personality disorder patients |
| topic | borderline personality disorder naturalistic design stepped care psychodynamic effectiveness cost evaluation |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1493265/full |
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