Trial reportPloS one2018
Treatment of personality disorder using a whole of service stepped care approach: A cluster randomized controlled trial.
Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Crisis and acute mental health care for people who have been given a diagnosis of a 'personality disorder': a systematic review.BMC psychiatry · 2023Pooled it
- Crisis interventions for adults with borderline personality disorder.The Cochrane database of systematic reviews · 2022Pooled it
- Psychological interventions for antisocial personality disorder.The Cochrane database of systematic reviews · 2020Pooled it
- Moderating Factors for the Effectiveness of Brief Psychological Intervention for People With Probable Personality Disorder: Secondary Analysis of Data From the SPS Trial.Personality and mental health · 2026Trial
- Iconic Therapy for the reduction of borderline personality disorder symptoms among suicidal youth: a preliminary study.BMC psychiatry · 2022Trial
- Evaluation of a brief intervention within a stepped care whole of service model for personality disorder.BMC psychiatry · 2019Trial
- Why aggregated data falls short: an exploratory survey study on barriers and facilitators in implementing the stepped care model for mental health in primary care.BMC primary care · 2026Article
- Implementation and outcomes of a brief crisis intervention for adolescents with borderline personality features: a pre-post observational study.BMC psychiatry · 2026Observational
- Treatment of patients with borderline personality disorder in the emergency room? A scoping review.Frontiers in psychiatry · 2026Review
- Identification of Patterns of Hospitalizations in Child and Adolescent Mental Health Service.The journal of behavioral health services & research · 2025Article
- AIR therapy: a pilot study of a clinician-assisted e-therapy for adolescents with borderline personality disorder.Borderline personality disorder and emotion dysregulation · 2025Article
- Gender differences in treatment effectiveness for borderline personality disorder.Personality and mental health · 2025Article
- 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 · 2025Article
- Dialectical behavior therapy (DBT) in an assertive community treatment structure (ACT): testing integrated care borderline (ICB) in a randomized controlled trial (RECOVER).Borderline personality disorder and emotion dysregulation · 2024Article
- The evaluation of a stepped care approach for early intervention of borderline personality disorder.Borderline personality disorder and emotion dysregulation · 2024Article
- Efficacy and recommendations for the delivery of telehealth psychotherapy for people with personality disorder.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2024Article
- Patient perspectives on non-response to psychotherapy for borderline personality disorder: a qualitative study.Borderline personality disorder and emotion dysregulation · 2023Article
- Evaluation of a skills-based peer-led art therapy online-group for people with emotion dysregulation.Borderline personality disorder and emotion dysregulation · 2022Article
- Current state of the evidence on community treatments for people with complex emotional needs: a scoping review.BMC psychiatry · 2022Article
- Crisis-focused psychosocial interventions for borderline personality disorder: systematic review and narrative synthesis.BJPsych open · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesPeople with personality disorders are prevalent in emergency and inpatient mental health services. We examined whether implementing a stepped care model of psychological therapy reduces demand on hospital units by people with personality disorder, in a cluster randomized controlled trial.
methodA total of 642 inpatients (average age 36.8, 50.5% female) with a primary ICD-10 personality disorder were recruited during 18 months baseline, then monitored during an 18 month active trial phase. In the active trial phase two equivalent sites were randomised to either treatment as usual (TAU), or a whole of service intervention that diverted people away from hospital and into stepped care psychological therapy clinics. The study design was cost neutral, with no additional staff or resources deployed between sites. A linear mixed models analysis evaluated outcomes.
resultsAs predicted, demand on hospital services reduced significantly in the intervention compared to TAU site. The intervention site evidenced shorter bed days, from an average of 13.46 days at baseline to 4.28 days per admission, and patients were 1.3 times less likely to re-present to the emergency department compared to TAU. Direct cost savings for implementing the approach was estimated at USD$2,720 per patient per year. Limitations included not directly comparing individual symptom changes.
conclusionsUsing a whole of service stepped care model of treatment for personality disorder significantly reduced demand on hospital services.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.