CClinicalTrials.gg
CompletedNCT03418142REVISITUpdated Feb 24, 2020

Evaluating an Internet-Based Self-Management Intervention for Borderline

An interventional study of Priovi and CAU in Borderline Personality Disorder, sponsored by Gaia AG. Completed at 1 site in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-02-24.

Sponsored by Gaia AG · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
206
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The trial aims to evaluate the effectiveness of a novel internet intervention (Priovi), which was designed to introduce relevant schema therapy techniques to Persons with Borderline Personality Disorder (BPD). Therefore, 200 people with BPD will be recruited and randomized to two groups: (1) a control group, in which they may engage with any BPD treatment (Care-as-Usual, CAU) and receive access to Priovi after a delay of 12 months (i.e., CAU/wait list control group), or (2) to a treatment group that immediately receives 12-month access to Priovi and may also use CAU. The primary outcome measure is the score of the Borderline Personality Disorder Severity Index (BPDSI), collected at three, six and 12 month post-baseline.

Read the detailed description

In the treatment of psychological disorders, web-based self-help programs can be very helpful, especially when combined with psychotherapy. However, up to this point, there are no respective programs for patients with Borderline Personality Disorder (BPD), although this disorder is associated with severe personal suffering and requires time-consuming therapy, which, in many cases, cannot be provided, due to the lack of therapeutic supply.

In this study, treatment effects of the web-based self-help program Priovi on BPD symptom severity when added to treatment as usual will be investigated. Priovi is a comprehensive program, which is conceptually and substantially based on the schema therapeutic approach used in BPD patients. It contains interactive dialogues that can be accessed via computer or smartphone, illustrations, audios and motivating text messages.

After a phone pre-screen and a diagnostic evaluation conducted by a psychiatrist, 200 patients suffering from BPD will be randomized into either the intervention group or into the waitlist control group. Priovi's duration of use is one year, measuring points will be determined before beginning of treatment (T0) as well as after 3 (T1), 6 (T2), 9 (T3) and 12 months (T4). The primary outcome variable will be the score of the Borderline Personality Disorder Severity Index (BPDSI), a highly reliable external assessment tool measuring BPD severity. Secondary outcome variables will be BPD symptom severity (as assessed by self-ratings), symptom severity of depression and anxiety as well as quality of life. The study will be collaboratively conducted by the University of Lübeck and the GAIA AG in Hamburg.

In this study, Priovi for BPD patients will be tested in a randomized controlled trial. It will be used as add-on therapy combined with any guideline therapy available to the respective patients. In doing so, the following hypothesis will be investigated: Compared to patients, who exclusively receive treatment as usual, the additional use of the self-help program in question will lead to a stronger decrease in BPD symptom severity.

02

Conditions studied

  • Borderline Personality Disorder
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Psychiatric diagnosis of BPD
  • BPDSI score of 15 or higher
  • Informed consent
  • German language proficiency
  • Willingness to participate in diagnostic and follow-up assessments as well as to see a -
  • Psychiatrist for validation of diagnosis
  • 18 years or older

Exclusion criteria

Exclusion Criteria:

  • Psychotic disorder
  • Primary psychiatric diagnosis of an addictive disorder
  • Schizotypal personality disorder
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
206 participants (actual)

Study arms

  • Experimental
    Priovi

    Priovi is an Internet-administered intervention for people with BPD.

    Behavioral: Priovi · Other: CAU

  • Active comparator
    Care-as-Usual (CAU) / wait list

    Additionaly, they will be informed about helpful and free available online self-help-proposals for BPD patients immediately after randomization.

    Other: CAU

Interventions

  • BehavioralPriovi

    Priovi is an Internet intervention for people with BPD. Content is continuously adapted to patients' concerns and needs. Priovi is a comprehensive program, which is conceptually and substantially based on the schema therapeutic approach used in BPD patients. It contains interactive dialogues that can be accessed via computer or smartphone, illustrations, audios and motivating text messages. Techniques to cope with borderline symptoms (e.g., psychoeducation about modes, schemas and basic emotional needs in addition to relevant strategies to weaken, reduce and/or heal maladaptive schemas and modes) are conveyed in interactive sequences that are accompanied by audio recordings, illustrations, and worksheets. Patients are also prompted to regularly complete brief symptom severity self-monitoring questionnaires. Optional daily text messages with motivational content accompany the program. The program can be accessed for 365 days after registration.

  • OtherCAU

    Care as Usual: In the CAU/wait list control group, participants are free to continue to engage with any treatment they require (i.e., CAU). However, they will receive access to Priovi after 12 months post-baseline (i.e., wait list with respect to Priovi access).

05

What researchers measure

Primary outcomes

  1. Score of the Borderline Personality Disorder Severity Index (BPDSI) - The BPDSI is a semi-structured interview assessing the frequency and severity of manifestations of borderline personality disorder (BPD) during the last three months.

    Semi-structured interview assessing BPD symptom frequency and severity

    Time frame: Changes from baseline to 3, 6 and 12 months

Secondary outcomes

  1. Severity of depressive symptoms, measured by Patient Health Questionnaire - 9 items (PHQ-9)

    Self-report depression symptom severity measure. Nine items, each of which is scored 0 to 3, providing a 0 to 27 severity score. Depression Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.

    Time frame: Changes from baseline to 3, 6, 9 and 12 months.

  2. GAD-7 (Generalized Anxiety Disorder Questionnaire)

    Self-report anxiety symptom severity measure. Seven items, each of which is scored 0 to 3, providing a 0 to 21 severity score. Anxiety Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-21 severe.

    Time frame: Changes from baseline to 3, 6, 9 and 12 months.

  3. EQ-5D (standardized instrument developed by the EuroQol Group as a measure of health-related quality of life.)

    Self-report measure of quality of life symptoms.

    Time frame: Changes from baseline to 3, 6, 9 and 12 months.

  4. BPD-Checklist short (Borderline personality Disorder Checklist short)

    Self-report measure of BPD symptoms.

    Time frame: Changes from baseline to 3, 6, 9 and 12 months.

  5. 2 Items of CIUS-Long-brief (Compulsive Internet Use Scale)

    Adapted self-report measure assessing potential compulsive internet use. two items, each of which is scored 1 to 5, providing a 2 to 10 severity score with higher values representing a worse outcome

    Time frame: Assessed at 3, 6, 9 and 12 months.

  6. NEQ (negative effects questionnaire)

    Self-report measure of potential negative effects of the treatment. qualitative measure.

    Time frame: Assessed at baseline, 3, 6, 9 and 12 months.

06

Study locations

1 site
  • Gaia AG
    Hamburg, 20144, Germany
07

References and documents

Publications

  • Klein JP, Hauer-von Mauschwitz A, Berger T, Fassbinder E, Mayer J, Borgwardt S, Wellhofer B, Schweiger U, Jacob G. Effectiveness and safety of the adjunctive use of an internet-based self-management intervention for borderline personality disorder in addition to care as usual: results from a randomised controlled trial. BMJ Open. 2021 Sep 8;11(9):e047771. doi: 10.1136/bmjopen-2020-047771. PubMed 34497078 ↗
  • Storebo OJ, Stoffers-Winterling JM, Vollm BA, Kongerslev MT, Mattivi JT, Jorgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020 May 4;5(5):CD012955. doi: 10.1002/14651858.CD012955.pub2. PubMed 32368793 ↗
  • Klein JP, Hauer A, Berger T, Fassbinder E, Schweiger U, Jacob G. Protocol for the REVISIT-BPD Trial, a Randomized Controlled Trial Testing the Effectiveness of an Internet-Based Self-Management Intervention in the Treatment of Borderline Personality Disorder (BPD). Front Psychiatry. 2018 Sep 21;9:439. doi: 10.3389/fpsyt.2018.00439. eCollection 2018. PubMed 30298024 ↗

Individual participant data

Plan to share: Yes — Anonymized individual participant data shall be made available upon request for projects such as meta-analyses after completion of the study

08

Registry details

Key details

Study ID
NCT03418142
Lead sponsor
Gaia AG
Collaborators
University of Luebeck
Responsible party
Sponsor
First posted
Feb 1, 2018
Start date
Jan 29, 2018
Primary completion
Jan 29, 2020
Completion
Jan 29, 2020
Last update
Feb 24, 2020

Study contacts

Jan Philipp Klein, Dr. med.
principal investigator · University of Lübeck, Zentrum für Integrative Psychiatrie ZiP gGmbH

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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