RecruitingNot ApplicableNCT06913738

Evaluation of a Dimensional Adaptation of Good Psychiatric Management (GPM-extended) for the Treatment of Borderline Personality Disorder

A Pragmatic Non-randomized Controlled Study Evaluating the Efficacy of a Dimensional Adaptation of Good Psychiatric Management (GPM-extended) Compared to a Classic Outpatient Good Psychiatric Management Treatment for Patient Fulfilling Criteria for Borderline Personality Disorder


Sponsor

AddiPsy

Enrollment

154 participants

Start Date

Jun 19, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to evaluate whether a dimensional adaptation of Good Psychiatric Management (called GPM-extended) is more effective than classic Good Psychiatric Management (GPM) in treating adult patients with borderline personality disorder (BPD). Briefly, the GPM-extended model integrates elements from existing adaptations of GPM for narcissistic and obsessive-compulsive personality disorders. It aims to provide a more personalized and dimensional approach to treatment, tailored to each patient's specific personality dysfunction and interpersonal triggers. The main questions it aims to answer are: * Does GPM-extended improve overall BPD symptom severity more than classic GPM after one year of treatment? * Does GPM-extended lead to better outcomes in related clinical domains (e.g., personality functioning, emotional regulation, social functioning...) ? Researchers will compare two groups: * Patients treated in a center using the GPM-extended program. * Patients treated in a center using the classic GPM program. In each group, patients will receive weekly outpatient psychiatric care for one year. In terms of evaluation, patients will be evaluated at baseline, 4 months, 8 months, and 1 year. They will undergo both clinician-administered and self-report assessments to measure BPD symptoms and other relevant psychological dimensions. This study hopes to contribute to the development of dimensional evidence-based treatments for personality disorders.


Eligibility

Min Age: 18 Years

Inclusion Criteria4

  • Adults (≥18 years old)
  • Diagnosis of borderline personality disorder according to the SCID-II (≥5 out of 9 criteria)
  • Provision of written informed consent
  • Affiliated with or beneficiary of the French national health insurance system

Exclusion Criteria5

  • Age under 18 years
  • Presence of a comorbid psychotic disorder, intellectual disability, severe antisocial traits, major substance use disorder incompatible with intensive therapy without abstinence, anorexia nervosa with somatic risk, or bipolar disorder in acute manic phase
  • Individuals under legal protection (e.g., guardianship or legal safeguard)
  • Individuals unable to cooperate or complete self- or clinician-administered questionnaires
  • Individuals not affiliated with or not beneficiaries of the French national health insurance system

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Interventions

BEHAVIORALGPM-Extended

GPM-extended is a dimensional adaptation of Good Psychiatric Management (GPM) that retains its core principles-validation, real-life focus, alliance building-while enhancing flexibility and personalization. It emphasizes diagnostic clarity, treatment prioritization, and individualized psychoeducation based on three key personality dilemmas: fear of abandonment, self-esteem dysregulation, and control dependency. These dilemmas guide the focus of therapy and case management. Treatment goals are collaboratively set and regularly reassessed to align with the patient's evolving needs. The intervention includes weekly individual therapy and tailored group programs, with clinical strategies adapted to each dominant dilemma.

BEHAVIORALClassic GPM

The classic GPM group follows the validated and manualized version of Good Psychiatric Management (GPM) for BPD. It emphasizes symptom stabilization through weekly individual therapy and pragmatic case management every 3 weeks. Unlike GPM-extended, it uses a uniform therapeutic framework rather than tailoring treatment to individual personality dilemmas,.The intervention includes weekly individual therapy and standardized group programs, with clinical strategies applied uniformly across patients, centered on interpersonal hypersensitivity and building stable life roles.


Locations(2)

Clinique Caradoc

Bayonne, France

Addipsy

Lyon, France

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NCT06913738


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