Treating co‐occurring first‐episode psychosis and borderline personality: a pilot randomized controlled trial
Abstract
Aim: First‐episode psychosis and borderline personality disorder are severe mental disorders that have their onset in youth. Their co‐occurrence is clinically well recognized, is associated with significant risks and is complex to treat. Yet, there is no published specific intervention for this problem. This study reports a pilot randomized controlled trial comparing combined specialist first‐episode treatment plus specialist early intervention for borderline personality, entitled Helping Young People Early, with specialist first‐episode treatment alone. We aimed to evaluate the safety and feasibility of adding early intervention for borderline personality. Methods: The study investigated the safety of specialist first‐episode treatment plus specialist early intervention for borderline personality in relation to deterioration in psychosis, aggression, self‐harm and suicidality, and feasibility in relation to the completion of therapy phases. Sixteen patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition‐Text Revision (DSM‐IV‐TR) criteria for first‐episode psychosis and borderline personality (four or more DSM‐IV criteria) were randomized either to specialist first‐episode treatment alone or specialist first‐episode treatment plus specialist early intervention for borderline personality and were followed up at the end of treatment and 6 months later. Results: The results showed that it was feasible to recruit and assess a high risk and complex group of patients who were agreeable to study participation. Specialist first‐episode treatment plus specialist early intervention for borderline personality was an acceptable and safe treatment. Conclusion: A larger‐scale randomized controlled trial of early intervention for borderline personality for young first‐episode psychosis patients with co‐occurring full or subsyndromal borderline personality is warranted.
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The majority of these trials did not show the superiority of the specialized treatments compared with treatment as usual.
“The results indicate that the majority of these trials did not show the superiority of the specialized treatments compared with treatment as usual.”
The evidence base for these adaptations is rather scarce; a recent review identified only ten randomized clinical trials.
“The evidence base for these adaptations is rather scarce. A recent review identified only ten randomized clinical trials [22–31].”
Dropout rates varied widely, ranging from 15 to 75%.
“Dropout rates varied widely, ranging from 15 to 75%.”
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- Authors
- Gleeson, J. F. M., Chanen, A., Cotton, S. M., Pearce, T., Newman, B., & McCutcheon, L.
- Affiliations
- Australian Catholic University (AU)
- The University of Melbourne (AU)
- Orygen Youth Health (AU)
- Corresponding author
- Gleeson, John F. M.
- Venue
- Early Intervention in Psychiatry
- Publisher
- Wiley
- Published
- 2011-11-16
- Volume
- 6
- Issue
- 1
- Pages
- 21-29
- ISSN
- 1751-7885 (ISSN-L)
- 1751-7893
- OpenAlex
- W1516789353
- Cited by
- 46
- References
- 41
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 2 · 2021: 6 · 2020: 6 · 2019: 2 · 2018: 4 · 2017: 1 · 2015: 2 · 2014: 4 · 2013: 1 · 2012: 2
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Early Intervention in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- first-episode psychosis, borderline personality disorder, comorbidities, youth mental health, treatment safety, treatment feasibility, aggression, self-harm, suicidality
- MeSH terms
- Adolescent, Adult, Borderline Personality Disorder, Female, Humans, Male, Patient Dropouts, Pilot Projects, Psychiatric Status Rating Scales, Psychotic Disorders, Cognitive Behavioral Therapy, Early Diagnosis, Early Medical Intervention
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