To study the (cost-)effectiveness of group schema-focused therapy (SFT) enriched with psychomotor therapy (PMT) in specialized mental health care for older adults. It is hypothesized that group SFT+PMT is cost-effective and superior to treatment as…
ID
Source
Brief title
Condition
- Personality disorders and disturbances in behaviour
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Primary outcome is general psychological distress (Brief Symptom Inventory;
BSI-53). Cost-effectiveness analysis will be performed from a societal
perspective (based on EQ-5D-5L and structured cost-interviews).
Secondary outcome
Secondary outcome measures are: quality of life and psychotropic drug use.
Background summary
The disease burden due to personality disorders is high for patients (lowered
quality of life, high levels of psychological distress) and society (increased
medical consumption and informal care). A personality disorder is found in more
than one third of geriatric psychiatric outpatients, and presence of a comorbid
personality disorder worsens treatment outcome for affective disorders. For
long, personality disorders were considered treatment resistant, but the past
decades several psychological therapies - including schema-focused therapy -
have been proven successful. However, personality disorders often remain
undiagnosed in geriatric psychiatry, and specific treatment for personality
disorders is often not available. Patients are therefore commonly offered
treatment for symptoms of depression, anxiety or somatization, leaving their
underlying personality pathology untreated.
Study objective
To study the (cost-)effectiveness of group schema-focused therapy (SFT)
enriched with psychomotor therapy (PMT) in specialized mental health care for
older adults. It is hypothesized that group SFT+PMT is cost-effective and
superior to treatment as usual (TAU) in reducing psychological distress and
improving quality of life.
Study design
A multicenter, randomized trial, with one-year follow-up, comparing the
treatment effect of group SFT+PMT to that of TAU.
Intervention
Twenty sessions of group SFT+PMT delivered in groups of 4 through 8 older
patients over a 6-month period.
Study burden and risks
Before patients can participate in the study, eligibility is checked in a 90
minutes diagnostic interview with a local researcher (psychologist), and
baseline characteristics are assessed by questionnaire (estimated to take 49
minutes) and interview (20 minutes).
Group SFT+PMT treatment consists of 20 three-hour sessions (2 hours
psychotherapy and 1 hour PMT) over a 6-month period. As part of treatment,
patients in the intervention group will score the severity of their schemas and
modes on a weekly basis (taking two minutes each time). Outcome assessment in
both study groups consists of questionnaires (taking 52 minutes), telephone
interviews (one week after the questionnaires, taking 30 minutes) and an
experience sampling measure by smartphone (3 times a day, during one week,
taking 42 minutes in total). These assessments are administered at the start
and end of treatment, and 6 and 12 months post-treatment.
Group SFT is a specific form of psychotherapy, aimed at reducing current and
future psychological distress, and PMT is added to enhance treatment effect by
experiential - bodily - techniques. PMT will be adapted to the physical
abilities of individual participants. We do not expect any risk associated with
participation in the study, and therefore applied for exemption from the
compulsory insurance for study participants.
Hanzeplein 1
Groningen 9713 EC
NL
Hanzeplein 1
Groningen 9713 EC
NL
Listed location countries
Age
Inclusion criteria
- Age: 60 years or older
- Cluster B or C personality disorder
- Mentally able to adhere to the group schema-focused treatment schedule and to fill out the schema (-mode) questionnaires
- Informed consent for the study
Exclusion criteria
- Severe mental illness, including current bipolar disorder or psychosis, or substance abuse disorder needing clinical detoxification.
- An established neurodegenerative disorder or cognitive impairment defined as a Montreal Cognitive Assessment (MoCA) sum score below 24 points.
- Prior schema-focused therapy, received in the previous year or during the present episode of illness.
- Immediate suicide risk interfering with adequate treatment delivery.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL59382.042.16 |