Outcome of a psychotherapeutic programme for patients with severe personality disorders

A specialized psychotherapeutic day treatment programme was established in a Danish clinical setting on the basis of recent research and advances in treatment for severe personality disorders. This study analyses treatment effectiveness by comparing the day treatment programme with a treatment as usual (TAU) situation as given to personality-disordered patients on a waiting list. The sample consisted of 66 personality-disordered patients consecutively referred and diagnosed according to standardized criteria. The intervention group comprised 38 patients. There was no selection made for the intervention group: when the programme capacity was reached, a waiting list of 28 consecutive patients formed the comparison group; none of these patients figured in the intervention group. Intervention included psychodynamic and cognitive-based therapy in a group/individual setting and lasted 5 months. Outcome measures were self-rated and observer-rated multidimensional evaluation of functioning relevant to personality-disordered patients. The day treatment programme did significantly better in reducing acute and prolonged hospitalizations and suicide attempts, in stabilizing the psychosocial functioning and in reducing complaints that lead to treatment. The intensive day treatment programme stabilized patient functioning but did not lead to changes on personality traits for which more extended treatment might be necessary.