Preliminary results of the TREBEA program, an outpatient comprehensive treatment for borderline personality disorder, in a region of northern Spain (Basque Country)
P. Garcia De Pascual, F. Hernandez Alvarez, P. Leunda Echave, B. Gil Fernandez, R. Ule Pozo, Y. Rodriguez Garcia, F. Turriago Bernal, J. Alvarez Benito, C. Ludwig, E. Lopez de Munain BlancoIntroduction
Personality disorders (PD) are a heterogeneous group of mental disorders characterized by maladaptive patterns of thinking, feeling, perceiving, and behaving. It is estimated that approximately 12% of the general population in Western countries meets the criteria for a PD diagnosis (Volkert et al ., 2018).
Borderline Personality Disorder (BPD) is a PD characterized by a persistent pattern of instability in interpersonal relationships, self-image, emotions, and behavior. PDs have been associated with higher psychiatric comorbidity, 85% of people whith PD diagnosis have at least one other mental disorder of the DSM-5. They also have higher rates of self-harm, suicidal ideation, and suicide risk (Hiroeh et al. , 2001).
The TREBEA outpatient program is a comprehensive treatment for patients with BPD, which has an interdisciplinary and cross-cultural approach.This program takes place in Gipuzkoa, an area in northern Spain located in the Basque Country. Most interventions are based on dialectical behavioral therapy (DBT), most validated therapy and empirical evidence for the treatment of BPD (Gale et al. , 2022).
Objectives
The TREBEA program would have three main objectives:
Clinical: Implementation of validated and effective therapeutic interventions for patients with BPD. Research: Evaluation of the effectiveness of interventions implemented in our population and study of factors that influence the clinical course of patients with BPD. Academic: Conducting training activities for the Gipuzkoa mental health network and training therapists and trainees
Methods
Patients are referred from 13 mental health centers in Gipuzkoa, part of the Basque country (nothern Spain).
The assessment includes an extensive questionnaire on sociodemographic data, which provides information on medical history, clinical course, current symptoms, comorbidities, pharmacological treatment, psychosocial functioning, and other significant factors.
In adition, we also include a structured interview, The Diagnostic Interview for Borderlines-Revised (DIB-R) and various self-report questionnaires are administered, such as CORE-OM, BSL-23, and ICG-TLP.
This assessment is conducted before and after the intervention. The program lasts 16 weeks and is based on Dialectical Behavior Therapy (DBT). Patients can complete up to 32 weeks.
Results
Patients included in the TREBEA program show a significant reduction in the frequency of self-harming and impulsive behaviors, a decrease in symptom severity, and an improvement in psychosocial functioning (Image 2). In addition, there is a reduction in the number of emergency room visits and hospital admissions at the end of the program and six months after the intervention.
Image 1: Long description.