Krankheitskosten der Borderline Persönlichkeitsstörung aus gesellschaftlicher Perspektive

Wagner, Till; Röepke, Stefan; Marschall, Paul; Stiglmayr, Christian; Renneberg, Babette; Gieb, Dieter; Dambacher, Claudia; Matthies, Sara; Salbach‐Andrae, Harriet; Fleßa, Steffen; Fydrich, Thomas

doi:10.1026/1616-3443/a000227

Cited by 31 publications

(25 citation statements)

References 74 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The annual costs for untreated BPD in Germany are estimated to be 8.69 billion € annually (Wunsch et al, 2014). Most of the costs are incurred by hospitalizations and day treatment (Wagner et al, 2013). …”

Section: Introductionmentioning

confidence: 99%

Feasibility of Group Schema Therapy for Outpatients with Severe Borderline Personality Disorder in Germany: A Pilot Study with Three Year Follow-Up

et al. 2016

View full text Add to dashboard Cite

Borderline Personality Disorder (BPD) is a severe, challenging to treat mental disorder. Schema therapy (ST) as an individual therapy has been proven to be an effective psychological treatment for BPD. A group format of ST (GST) has been developed and evaluated in a randomized controlled trial in the United States and piloted in The Netherlands. These results suggest that GST speeds up and amplifies treatment effects of ST and might reduce delivery costs. However, feasibility in the German health care system and with BPD patients with high BPD severity and comorbidity, and frequent hospitalization, has not been tested to date. We investigated GST in 10 severely impaired, highly comorbid female patients with BPD, that needed frequent hospital admission. Patients received an outpatient ST-treatment program with weekly group and individual sessions for 1 year. Outcome measures including BPD severity, general psychopathology, psychosocial functioning, quality of life, happiness, schemas, and modes, and days of hospitalization were assessed at the start of treatment and 6, 12, and 36 months later with semi-structured interviews and self-report measures. We observed significant decreases in severity of BPD symptoms, general symptom severity, dysfunctional BPD-specific modes and schemas, and days of hospitalization. Functional modes, quality of live and happiness improved. The results of this feasibility study are promising and encourage further implementation of ST outpatient treatment programs even for patients with severe BPD and high hospitalization risk. However, small sample size and the missing of a control group do not allow the generalizability of these findings.

show abstract

Section: Introductionmentioning

confidence: 99%

Feasibility of Group Schema Therapy for Outpatients with Severe Borderline Personality Disorder in Germany: A Pilot Study with Three Year Follow-Up

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Jerschke und Kollegen [12] berechneten für BPS-Patientinnen durchschnittliche direkte Kosten von € 15 206 (1995: DM 24 000) pro Jahr. Wagner und Kollegen [13] ermittelten mittlere direkte medizinische Kosten von € 17 089 pro Jahr. In diesen beiden bundesdeutschen Studien stellte die stationäre Behandlung die kostenintensivste Position dar.…”

Section: Introductionunclassified

Psychiatrische Behandlungskosten von Patientinnen mit Posttraumatischer Belastungsstörung nach sexuellem Missbrauch vor und nach stationärer DBT-PTSD

et al. 2016

View full text Add to dashboard Cite

In Germany, patients with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (CSA) often receive inpatient treatment. However, data on utilization and costs of mental health care as well as on the impact of trauma-focused treatment are missing. Within the context of a randomized controlled trial mental health service utilization was assessed in female patients with PTSD related to CSA. Data on psychiatric-psychotherapeutic inpatient and outpatient treatment and psychotropic medication was obtained for the year before and after inpatient DBT-PTSD. The mean total costs of utilization of psychiatric-psychotherapeutic care and use of psychotropics were € 18.100 per patient in the year before and € 7.233 in the year after DBT-PTSD. The significant cost decrease was due to large reductions in inpatient treatment days (on average 57 days before and 14 days after DBT-PTSD), while outpatient treatment and psychotropic medication remained unchanged. PTSD related to CSA is associated with high utilization and costs of mental health care. The results suggest that DBT-PTSD might contribute to reducing the mental health care costs.

show abstract

“…The burden of BPD on society in terms of productivity losses and other indirect costs is assumed to reach 76.3% of the total costs (Olesen, Gustavsson, Svensson, Wittchen, & Jönsson, 2012). Similarly, direct costs of BDP are considered to be higher than in depression or diabetes (Wagner et al, 2013), with average per capita costs ranging between 11,000€ and 14,000€ (Salvador-Carulla et al, 2014) per year. In sum, BPD is a severe treatment condition that comes with a high burden for the individual and society.…”

Section: Borderline Personality Disordermentioning

confidence: 99%

Evidence-Based Psychodynamic Therapies for the Treatment of Patients With Borderline Personality Disorder

Taubner

Volkert

2019

CPE

View full text Add to dashboard Cite

Borderline Personality Disorder (BPD) is a serious health issue associated with a high burden for the individual and society. Among the “Big Four” of evidence-based treatments for patients with BPD are two psychodynamic therapies that have evolved from classic psychoanalytic treatment with a change of setting and change of focus: Transference-Focused Psychotherapy (TFP) and Mentalization-Based Treatment (MBT). This overview provides a comparison of the two treatments in terms of stance, clinical concepts, costs and key interventions. Furthermore, the current literature on the efficacy of both treatments is reviewed. While TFP focuses on the content of disintegrated representations of self and other, MBT focuses on the processing of mental states. Both treatments diverge in their clinical concepts and interventions for the treatment of BPD. Although both treatments are regarded as effective in treating BPD, no direct comparison of both treatments has been made so far. Future studies are needed to investigate mechanisms of change and derive recommendations for a differential indication. Specialized therapies for BPD have favorable drop-out rates and outcome compared to non-specialized ones. MBT and TFP have very diverse clinical concepts and interventions for the treatment of BPD. Both, MBT and TFP show efficacy in RCTs. No trial has directly compared MBT and TFP; there is no evidence base for differential indication. Specialized therapies for BPD have favorable drop-out rates and outcome compared to non-specialized ones. MBT and TFP have very diverse clinical concepts and interventions for the treatment of BPD. Both, MBT and TFP show efficacy in RCTs. No trial has directly compared MBT and TFP; there is no evidence base for differential indication.

show abstract

Krankheitskosten der Borderline Persönlichkeitsstörung aus gesellschaftlicher Perspektive

Cited by 31 publications

References 74 publications

Feasibility of Group Schema Therapy for Outpatients with Severe Borderline Personality Disorder in Germany: A Pilot Study with Three Year Follow-Up

Feasibility of Group Schema Therapy for Outpatients with Severe Borderline Personality Disorder in Germany: A Pilot Study with Three Year Follow-Up

Psychiatrische Behandlungskosten von Patientinnen mit Posttraumatischer Belastungsstörung nach sexuellem Missbrauch vor und nach stationärer DBT-PTSD

Evidence-Based Psychodynamic Therapies for the Treatment of Patients With Borderline Personality Disorder

Contact Info

Product

Resources

About