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A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skåne randomized controlled trial protocol (BASRCT) : Study Protocol

Liljedahl, Sophie LU ; Helleman, Marjolein; Daukantaité, Daiva LU ; Westrin, Åsa LU and Westling, Sofie LU (2017) In BMC Psychiatry 17(220).
Abstract
Background: Brief Admission is a crisis and risk management strategy in which self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder self-admit to hospital at times of increasing risk when other efforts to stay safe are failing. Standardized in the current randomized controlled trial, the intensity of Brief Admission Skåne is implemented in durations of three days, with a maximum frequency of three times a month. Brief Admission is integrated into existing treatment plans in advance of crises to prevent reliance on general psychiatric admissions for risk management, as these may be lengthy, unstructured, and of uncertain therapeutic value.
Methods/design: The overall objective... (More)
Background: Brief Admission is a crisis and risk management strategy in which self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder self-admit to hospital at times of increasing risk when other efforts to stay safe are failing. Standardized in the current randomized controlled trial, the intensity of Brief Admission Skåne is implemented in durations of three days, with a maximum frequency of three times a month. Brief Admission is integrated into existing treatment plans in advance of crises to prevent reliance on general psychiatric admissions for risk management, as these may be lengthy, unstructured, and of uncertain therapeutic value.
Methods/design: The overall objective of the Brief Admission Skåne randomized controlled trial is to determine if Brief Admission can replace general psychiatric admission for self-harming and suicidal individuals with complex mental illness at times of escalating risk. Other objectives of the study are to evaluate whether Brief Admission increases daily functioning and enhances coping, reduces psychiatric symptoms including frequency and severity of self-harm and suicidal behaviours. A final objective is to determine if Brief Admission is an effective crisis management model for this population. Participants are randomized at an individual level to either Brief Admission Skåne plus Treatment as Usual or Treatment As Usual. Based on a priori power analyses, N = 124 participants will be recruited to the study. Data collection is in progress, and will continue until June 2018. All participant data are single-blinded and will be handled with intention-to-treat analysis.
Discussion: Based on the combined clinical experience of our international research group, the Brief AdmissionSkåne randomized controlled trial upon which the current protocol is based represents th e first initiative tostandardize, implement and evaluate Brief Admission amongst self-harming and suicidal individuals, including thosewith borderline traits. Objectively measuring protocol fidelity and developing English-language Brief Admissionstudy protocols and training materials are implementation and dissemination targets developed in order tofacilitate adherent international export of Brief Admission Skåne.Trial registration: NCT02985047. Registered November 25, 2016. Retrospectively registered. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Brief admission Skåne, Self-harm, Suicide, Borderline Personality Disorder, BASRCT
in
BMC Psychiatry
volume
17
issue
220
pages
15 pages
publisher
BioMed Central
external identifiers
  • wos:000405812800001
  • scopus:85027564577
ISSN
1471-244X
DOI
10.1186/s12888-017-1371-6
language
English
LU publication?
yes
id
15dbc224-8042-4b22-9d18-9c4fcc8fab35
alternative location
https://link.springer.com/epdf/10.1186/s12888-017-1371-6?author_access_token=Hj6qXpvo_z5Ekg-5JV2JsG_BpE1tBhCbnbw3BuzI2RPzNlWBNn-2hRCsThvJEEmq953LxtVqlR3cB9mCsOLHDArQGvi5yY7JTKsldf--LjT_Or88cOBAfq6wMpu0bERWDV1G05QG6DeDU1JEJfLFZA==
date added to LUP
2017-06-16 17:41:41
date last changed
2017-11-14 09:54:47
@article{15dbc224-8042-4b22-9d18-9c4fcc8fab35,
  abstract     = {Background: Brief Admission is a crisis and risk management strategy in which self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder self-admit to hospital at times of increasing risk when other efforts to stay safe are failing. Standardized in the current randomized controlled trial, the intensity of Brief Admission Skåne is implemented in durations of three days, with a maximum frequency of three times a month. Brief Admission is integrated into existing treatment plans in advance of crises to prevent reliance on general psychiatric admissions for risk management, as these may be lengthy, unstructured, and of uncertain therapeutic value. <br/>Methods/design: The overall objective of the Brief Admission Skåne randomized controlled trial is to determine if Brief Admission can replace general psychiatric admission for self-harming and suicidal individuals with complex mental illness at times of escalating risk. Other objectives of the study are to evaluate whether Brief Admission increases daily functioning and enhances coping, reduces psychiatric symptoms including frequency and severity of self-harm and suicidal behaviours. A final objective is to determine if Brief Admission is an effective crisis management model for this population. Participants are randomized at an individual level to either Brief Admission Skåne plus Treatment as Usual or Treatment As Usual. Based on a priori power analyses, N = 124 participants will be recruited to the study. Data collection is in progress, and will continue until June 2018. All participant data are single-blinded and will be handled with intention-to-treat analysis.<br/>Discussion: Based on the combined clinical experience of our international research group, the Brief AdmissionSkåne randomized controlled trial upon which the current protocol is based represents th e first initiative tostandardize, implement and evaluate Brief Admission amongst self-harming and suicidal individuals, including thosewith borderline traits. Objectively measuring protocol fidelity and developing English-language Brief Admissionstudy protocols and training materials are implementation and dissemination targets developed in order tofacilitate adherent international export of Brief Admission Skåne.Trial registration: NCT02985047. Registered November 25, 2016. Retrospectively registered.},
  author       = {Liljedahl, Sophie and  Helleman, Marjolein and Daukantaité, Daiva and Westrin, Åsa and Westling, Sofie},
  issn         = {1471-244X},
  keyword      = {Brief admission Skåne,Self-harm,Suicide,Borderline Personality Disorder,BASRCT},
  language     = {eng},
  month        = {06},
  number       = {220},
  pages        = {15},
  publisher    = {BioMed Central},
  series       = {BMC Psychiatry},
  title        = {A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skåne randomized controlled trial protocol (BASRCT) : Study Protocol},
  url          = {http://dx.doi.org/10.1186/s12888-017-1371-6},
  volume       = {17},
  year         = {2017},
}