Influence of therapist competence and quantity of cognitive behavioural therapy on suicidal behaviour and inpatient hospitalisation in a randomised controlled trial in borderline personality disorder: further analyses of treatment effects in the BOSCOT study.
Bottom Line: A total of 101 participants provided full outcome data at 2 years post randomization.The previously reported intention-to-treat (ITT) results showed on average a reduction of 0.91 (95% confidence interval 0.15-1.67) suicidal acts over 2 years for those randomized to CBT.By incorporating the influence of quantity of therapy and therapist competence, we show that this estimate of the effect of CBTpd could be approximately two to three times greater for those receiving the right amount of therapy from a competent therapist.
Affiliation: Centre for Healthcare Randomised Trials, Health Services Research Unit, Aberdeen University, UK.Show MeSH
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Mentions: A similar analysis for inpatient psychiatric hospitalizations (IPH) excluded events within the first 182 days after randomization. The numbers of participants with at least one IPH falls from the original 23 (47%) for TAU to 18 (34%) compared with CBTpd rates of 12 (24%) and 14 (27%), respectively, over the remaining 18 months. Interestingly, then, the event rate is much higher in the first 6 months (Figure 2). Therefore, for IPH, the reverse may be true – a treatment effect that manifests early and then disappears, which may be a quite common phenomenon seen across a variety of therapeutic interventions.
Affiliation: Centre for Healthcare Randomised Trials, Health Services Research Unit, Aberdeen University, UK.