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. 2020 Sep 3;2020(9):CD007668. doi: 10.1002/14651858.CD007668.pub3

Clarke 2013.

Methods Design: randomised control trial
Participants Participants: individuals with personality disorder referred to a specialist outpatient service
Sex:a 28 men, 71 women
Age:a mean age = 36.0 years (SD = 9.5, range = 19‐59)
Unit of allocation: individual, stratified by cluster
Number randomised: experimental group (n = 50); control/TAU group (n = 49)
Number completing: experimental group (n = 38), control/TAU group (n = 40)
Setting: specialist outpatient clinic of public health service (NHS, UK)
Inclusion criteria: participants met diagnostic criteria for a personality disorder; participants had completed at least one previous episode of therapy (see note 2)
Exclusion criteria: diagnosis of psychotic illness, substance dependence or intellectual disability based on DSM‐IV criteria; participant reports self‐harming behaviour on at least a monthly basis
Ethnicity: not stated
Baseline characteristics:a 88% of the sample had a diagnosis of two or more personality disorders; 53% displayed diagnoses across two clusters; 28% across all three clusters; 68% of participants had a diagnosis of borderline personality disorder
Interventions Two conditions: cognitive analytic therapy (CAT); or treatment‐as‐usual (TAU)
  • Experimental group: CAT + TAU

  • Control group: TAU


Details of conditions:
  • CAT described as following the principles outlined by Ryle 2002 and guidelines developed by the Association of Cognitive Analytic Therapy (ACAT); participants in the CAT condition were offered 24 sessions of CAT and 3 follow‐up sessions at 3, 6 and 12 months after termination of weekly therapy plus usual care.

  • TAU described as usual NHS standard care including "...care from community mental health team, clinical services and contact with a general practitioner." (quote; p 130)


Duration of intervention: 24 sessions
Duration of trial: 10 months
Length of follow‐up: 12 months
Outcomes Secondary outcomes
  • Satisfaction with treatment: Service Satisfaction Scale

  • Mental state: symptoms of personality disorder (Structured Clinical Interview for DSM‐IV Axis II); global distress (Clinical Outcomes in Routine Evaluation); Dissociation (Dissociative Questionnaire; Dissociative Experiences Scale); Symptom Checklist‐90‐Revised

  • Prison and service outcomes, treatment of people in the community

  • Frequency and duration of all accident and emergency attendances

  • Frequency and duration inpatient admissions including those for general health difficulties


Other outcomes
  • Interpersonal problems: Inventory of Interpersonal Problems (32 items)

Notes aFor all of those randomised (n = 99) at least 18 participants had a cluster B personality disorder. Author (Susan Clarke) contacted by email on 19 January 2017 with request to identify the number of participants with AsPD; no data for AsPD subset. No response received (Clarke 2013)