{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:21:07Z","timestamp":1790857267565,"version":"4.1.0"},"reference-count":39,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec id=\"S0007125024000564_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Higher intensity of psychotherapy might improve treatment outcome in depression, especially in those with comorbid personality disorder.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125024000564_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>To compare the effects of 25 individual sessions (weekly) of two forms of psychotherapy \u2013 short-term psychoanalytic supportive psychotherapy (SPSP) and schema therapy \u2013 with the same treatments given for 50 sessions (twice weekly) in people with depression and personality disorder. Trial registration: NTR5941.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125024000564_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>We conducted a pragmatic, double-randomised clinical trial and, over 37 months, recruited 246 adult out-patients with comorbid depression\/dysthymia and personality disorder. A 2 \u00d7 2 factorial design randomised participants to 25 or 50 sessions of SPSP or schema therapy. The primary outcome was change in depression severity over 1 year on the Beck Depression Inventory II (BDI-II). Secondary outcomes were remission both of depression and personality disorder.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125024000564_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Compared with 25 sessions, participants who received 50 sessions showed a significantly greater decrease in depressive symptoms over time (time \u00d7 session dosage, <jats:italic>P<\/jats:italic> &lt; 0.001), with a mean difference of 5.6 BDI points after 1 year (<jats:italic>d =<\/jats:italic> \u22120.53, 95% CI \u22120.18 to 0.882, <jats:italic>P<\/jats:italic> = 0.003). Remission from depression was also greater in the 50-session group (74% <jats:italic>v.<\/jats:italic> 58%, <jats:italic>P<\/jats:italic> = 0.025), as was remission of personality disorder (74% <jats:italic>v.<\/jats:italic> 56%, <jats:italic>P =<\/jats:italic> 0.010).<\/jats:p><\/jats:sec><jats:sec id=\"S0007125024000564_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Greater intensity of psychotherapy leads to better outcomes of both depression and personality status in people with comorbid depression and personality disorder.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.2024.56","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T09:52:20Z","timestamp":1712829140000},"page":"274-281","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Dosage effects of psychodynamic and schema therapy in people with comorbid depression and personality disorder: four-arm pragmatic randomised controlled trial"],"prefix":"10.1192","volume":"225","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4862-8310","authenticated-orcid":false,"given":"Marit","family":"Kool","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henricus","family":"Van","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnoud","family":"Arntz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Bartak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap","family":"Peen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Dil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katinka","family":"de Boer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Dekker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2024,4,11]]},"reference":[{"key":"S0007125024000564_ref21","volume-title":"Schema Therapy: A Practitioner's Guide","author":"Young","year":"2003"},{"key":"S0007125024000564_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.08.023"},{"key":"S0007125024000564_ref29","volume-title":"The Schema Mode Inventory","author":"Young","year":"2007"},{"key":"S0007125024000564_ref38","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.68.3.438"},{"key":"S0007125024000564_ref10","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.62.5.1009"},{"key":"S0007125024000564_ref14","volume-title":"Mini International Neuropsychiatric Interview Plus","author":"Sheehan","year":"2000"},{"key":"S0007125024000564_ref26","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.20.1.23"},{"key":"S0007125024000564_ref6","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2011.598580"},{"key":"S0007125024000564_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.06.034"},{"key":"S0007125024000564_ref5","doi-asserted-by":"publisher","DOI":"10.1080\/10673220303950"},{"key":"S0007125024000564_ref9","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2019.265"},{"key":"S0007125024000564_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1829-1"},{"key":"S0007125024000564_ref27","doi-asserted-by":"publisher","DOI":"10.1097\/PRA.0000000000000323"},{"key":"S0007125024000564_ref24","doi-asserted-by":"publisher","DOI":"10.1111\/cpsp.12032"},{"key":"S0007125024000564_ref33","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-007-0753-5_1226"},{"key":"S0007125024000564_ref31","first-page":"191","volume-title":"The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}