Upstate News

November 2, 2004
Doretta Royer 315 464-4833

SUNY Upstate initiaties personality disorder study

SYRACUSE, N.Y. — Researchers at SUNY Upstate Medical University are conducting a study, the findings of which may lead to the nation’s first scientifically proven method to treat a mental and behavioral condition that profoundly alters a person’s quality of life.

The study tests psychodynamic psychotherapy (PT) as an effective method to treat persons with borderline personality disorder (BPD) who abuse alcohol or are alcohol dependent. Findings may provide the science needed to justify a larger, more definitive study, possibly giving the medical community the evidence needed to make PT standard care for this population.

The one-year randomized controlled trial, “Psychodynamic Therapy for Patients With Borderline Personality Disorder and Alcohol Abuse,” is funded through a $30,730 grant from the Hendrick’s Foundation. The principal investigator is Robert J. Gregory, M.D., associate professor of psychiatry.

PT deals with the mental or emotional forces or processes developed in early childhood and their effects on current behavior and mental states. It promotes the development of healthy and non-abusive relationships through identifying and resolving unconscious conflicts that underlie BPD.

BPD and alcoholism are conditions that can cause mood instability, self-destructive behaviors, decreased social and occupational functioning and are associated with significant mortality. “New treatment methods and outcome research are desperately needed to effectively treat this patient population,” said Gregory.

The current accepted method of BPD treatment is through psychotropic medication combined with dialectical behavior therapy (DBT) which teaches new coping strategies and behaviors but does not delve into the unconscious conflicts that are at the root of the disorder. “Psychotropic medications have been shown to have minimal effect on BPD,” said Gregory. “DBT has had mixed results for persons with BPD and alcoholism and long-term outcomes are still not known. ”

Gregory and his associates are recruiting volunteers from CPEP and from University, St. Joseph’s and Community General hospitals. The clinical trial site is SUNY Upstate’s Adult Psychiatry Clinic. Study volunteers will be randomized to either a study group receiving weekly PT or to a control group receiving their usual care in the community. There is a target enrollment of 15 volunteers in each group and a 12-month duration. Outcome measures, to be administered at enrollment and at three-month intervals, include numbers of non-participants and study dropouts, as well as standardized measures of self-harm, depression, relationships, alcohol use, and utilization of the health care system.

The study will also evaluate the feasibility of a manualized, semi-structured, individual psychodynamic therapy approach to the treatment of BPD; overall study design; difficulties in patient recruitment and retention; and the amount of on-going supervision of therapists that is required.

BPD is a debilitating condition affecting one to two percent of the population with a much higher prevalence in medical and psychiatric settings. Twenty percent of psychiatric inpatients and 10 percent of outpatients in mental health clinics have BPD; 10 percent of individuals with this disorder will complete suicides some time in their lives.

Joining Gregory in the study are Kathleen Deters Hayes, M.S.W., David Kang, M.D., Mihai Simonescu, M.D., Jason Stepkovitch, M.D., and Subhdeep Virk, M.D., of SUNY Upstate’s Department of Psychiatry. Anna Remen, Ph.D., is the study coordinator.

For more information on the study, call Gregory at (315) 464-3169 or Remen at (315) 464-3167.

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