Health related quality of life for young people receiving dialectical behaviour therapy (DBT): a routine outcome-monitoring pilot
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PURPOSE: Adults presenting with borderline personality disorder (BPD) score poorly on measures of health related quality of life (HRQoL). Little is known about HRQoL in adolescents with BPD type presentations and how treatment impacts quality of life. Our primary aim was to use routinely collected quality-of-life outcome measures pre and post-treatment in dialectical behaviour therapy (DBT) for adolescents to address this gap. Secondary aims were to benchmark these data against EuroQol 5 dimensions (EQ-5D™) outcomes for clients treated in clinical trials and to assess the potential of the EQ-5D™ as a benchmarking tool. METHOD: Four adolescent DBT teams, routinely collecting outcome data using a pseudonymised secure web-based system, supplied data from consecutive discharges. RESULTS: Young people in the DBT programmes (n = 43) had severely impaired HRQoL scores that were lower at programme admission than those reported in published studies using the EQ-5D™ in adults with a BPD diagnosis and in one study of adolescents treated for depression. 40 % of adolescents treated achieved Reliable Clinical Change. HRQoL improved between admission and discharge with a large effect size. These results were not statistically significant when clustering in programme outcomes was accounted for. CONCLUSION: Young people treated in NHS DBT programmes for BPD type presentations had poorer HRQoL than adults with a BPD diagnosis and adolescents with depression treated in published clinical trials. The EQ-5D™ detected reliable change in this group of adolescents. Programme outcome clustering suggests that both the measure and the web-based monitoring system provide a mechanism for benchmarking clinical programmes.
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Post-treatment outcomes are consistent with previous studies showing that brief DBT formats result in significant decrease in depression, hopelessness, and quality of life at end of treatment.
“Post-treatment outcomes are consistent with previous studies showing that brief DBT formats result in a significant decrease in these clinical dimensions at the end of the treatment (Stanley et al., 2007; Mehlum et al., 2014; Swales et al., 2016; Sahranavard & Miri, 2018).”
From Feasibility, Acceptability and Preliminary Efficacy of Dialectical Behavior Therapy for Autistic Adults without Intellectual Disability: A Mixed Methods Study (2022) · cites this paper as Swales et al., 2016
The Background reports that a 16-week DBT-A trial found a significant decrease in depression. It does not establish a decrease in hopelessness. The Discussion and Results report that quality of life improved rather than decreased in this pilot, and that the improvement was not statistically significant after accounting for clustering; the pilot also had a longer average treatment duration than the brief format discussed. (LLM, conf=0.88)
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Self-citation
- Authors
- Swales, M., Hibbs, R. A. B., Bryning, L., & Hastings, R. P.
- Affiliations
- Betsi Cadwaladr University Health Board (GB)
- Bangor University (GB)
- University of Warwick (GB)
- Corresponding author
- Swales, M.
- Venue
- SpringerPlus
- Published
- 2016-07-20
- Volume
- 5
- Issue
- 1
- Pages
- 1137-1137
- ISSN
- 2193-1801 (ISSN-L)
- PMC
- PMC4954798
- OpenAlex
- W2478248526
- Cited by
- 9
- References
- 57
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2021: 3 · 2017: 1
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- SpringerPlus (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Bangor University Research Portal (Bangor University) (publishedVersion, other-oa)
- Funders
- Knowledge Economy Skills Scholarship Programme (KESS Mini 016)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- health-related quality of life, dialectical behavior therapy, borderline personality disorder, adolescents, routine outcome monitoring, EQ-5D, reliable change
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