{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T20:25:39Z","timestamp":1788294339465,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["171202012"],"award-info":[{"award-number":["171202012"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Personality &amp; Mental Health"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study examined the impact of clinical severity on treatment outcome in two programs that differ markedly in treatment intensity: day hospital mentalization\u2010based treatment (MBT\u2010DH) and intensive outpatient mentalization\u2010based treatment (MBT\u2010IOP) for borderline personality disorder (BPD). A multicenter randomized controlled trial was conducted. Participants include the full intention\u2010to\u2010treat sample of the original trial of <jats:italic>N<\/jats:italic>\u00a0=\u2009114 randomized BPD patients (MBT\u2010DH <jats:italic>n<\/jats:italic>\u00a0=\u200970, MBT\u2010IOP <jats:italic>n<\/jats:italic>\u00a0=\u200944), who were assessed at baseline and subsequently every 6 up to 36\u2009months after start of treatment. Outcomes were general symptom severity, borderline features, and interpersonal functioning. Clinical severity was examined in terms of severity of BPD, general symptom severity, comorbid symptom disorders, comorbid personality disorders, and cluster C personality features. None of the severity measures was related to treatment outcome or differentially predicted treatment outcome in MBT\u2010DH and MBT\u2010IOP, with the exception of a single moderating effect of co morbid symptom disorders on outcome in terms of BPD features, indicating less improvement in MBT\u2010DH for patients with more symptom disorders. Overall, patients with varying levels of clinical severity benefited equally from MBT\u2010DH and MBT\u2010IOP, indicating that clinical severity may not be a useful criterion to differentiate in treatment intensity.<\/jats:p>","DOI":"10.1002\/pmh.1603","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T07:28:00Z","timestamp":1706772480000},"page":"148-156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of clinical severity on treatment response in a randomized controlled trial comparing day hospital and intensive outpatient mentalization\u2010based treatment for borderline personality disorder"],"prefix":"10.1002","volume":"18","author":[{"given":"Maaike L.","family":"Smits","sequence":"first","affiliation":[{"name":"De Viersprong  Halsteren Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dine J.","family":"Feenstra","sequence":"additional","affiliation":[{"name":"De Viersprong  Halsteren Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs","family":"Blankers","sequence":"additional","affiliation":[{"name":"Department of Research Arkin Mental Health Care  Amsterdam Netherlands"},{"name":"Trimbos Institute Netherlands Institute of Mental Health and Addiction  Utrecht Netherlands"},{"name":"Amsterdam UMC, Location AMC, Department of Psychiatry University of Amsterdam  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan H.","family":"Kamphuis","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Amsterdam  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn L.","family":"Bales","sequence":"additional","affiliation":[{"name":"GGZ Breburg  Breda Netherlands"},{"name":"MBT\u2010Expertise  Breda Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack J. 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