Effective treatment helps Danes with personality disorders

For seven years, Carsten René Jørgensen from the Department of Psychology and Behavioural Sciences at Aarhus University has collaborated with the Clinic for Personality Disorders, Aarhus University Hospital, Risskov on examining the extent to which modern psychoanalytic psychotherapy can help the Danes suffering from severe borderline personality disorders.

Among the first to examine these forms of modern psychoanalytic treatment of severe personality disorders, the study shows a clear trend; a vast majority of patients do better after a two-year course of treatment.

- It is a patient population that has not been accustomed to receiving much treatment because it is a difficult group, and it has therefore been interesting to examine the effect of more intensive treatment, says Carsten René Jørgensen.

The study compares two forms of treatment. Supportive treatment with group therapy every two weeks and more intensive therapy with weekly sessions involving both group therapy and individual psychotherapy. Both forms of treatment are based on modern psychoanalytic principles.

To the researchers' surprise, both treatments proved highly effective. However, a distinctive feature of the intensive treatment was that patients in this group achieved a higher functional level, which probably indicates that they are more likely to gain a foothold in the labour market.

From public support to the labour market

Borderline personality disorders are among the more serious personality disorders where patients have difficulty dealing with interpersonal relationships and they often experience pronounced fluctuations in their emotions and self-perception. Patients may also be self-harming and have a highly increased risk of abuse and suicide attempts, among other things.

That is also the reason why up to 80% of these patients are publicly supported. The research results indicate, however, that the modern psychoanalytic psychotherapy may be part of the solution to get some of the patients closer to the labour market and self-reliance.

- These are people who suffer greatly, but this treatment helps them to feel better, see their strengths and weaknesses more clearly and become better at handling relations. They will better equip them to start, for example, an education or part-time work, explains Carsten René Jørgensen.

From a socioeconomic point of view it may therefore be beneficial to treat this patient group. Carsten René Jørgensen explains that although the treatment itself requires extensive resources, studies have shown that the socioeconomic savings by offering treatment are higher because the cost of emergency room visits, hospitalisations, local initiatives, benefits and other forms of treatment are reduced.

Facts about the study

• The study compared supportive group psychotherapy treatment and a more intensive therapy with both individual and group therapy. The intensive psychotherapy in particular aims at strengthening the patients' ability to understand themselves, their reactions and those of others as well as interpersonal interactions. Both treatments proved highly effective, but the intensive treatment had a greater effect on the patients' functional level, which is very important for their ability to function in society.
• The effect of the treatment presumably requires that it is performed by trained and experienced therapists and that it is conducted in a well-organised clinic. The treatment should also be relatively long-term -- two years and sometimes longer -- to have a decisive effect.
• The study started in 2005. 85 patients have started treatment of which 63 persons have completed two years of treatment. The average age of the patient is just under 30. All patients reside in Central Denmark Region, but the study results can easily be applied in other parts of the country.
• It is estimated that 10% of the adult Danish population are suffering from personality disorders of which 1-2% meet the criteria for severe borderline personality disorder.