Below is the citation and summary of a new paper in The Lancet Psychiatry, and a comment from me.
CITATION:
A digital therapeutic for people with borderline personality disorder in Germany (EPADIP-BPD): a pragmatic, assessor-blind, parallel-group, randomised controlled trial
Assmann, Nele et al.
The Lancet Psychiatry, Volume 12, Issue 5, 366 - 376
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00063-X/fulltext
SUMMARY
Background
Fewer than 25% of patients with borderline personality disorder (BPD) receive guideline-adherent psychotherapy. Digital therapeutics can help reduce this gap. Therefore, we tested the effectiveness and safety of priovi, a digital therapeutic for BPD.
Methods
We conducted a pragmatic, assessor-blind, parallel-group, randomised controlled trial, recruiting patients with BPD, according to DSM-5 classification, of at least moderate severity on the 23-item Borderline Symptom List (BSL-23) via online advertisements in Germany...
Findings
Between May 3 and Oct 20, 2022, 1766 patients were screened for eligibility and 580 patients (520 [90%] women, 47 [8%] men, and 13 [2%] gender diverse) were randomly assigned to the intervention group (n=302) and control group (n=278)... Regarding safety, there were significantly fewer suicide attempts in the intervention group (n=7) than in the control group (n=21; incidence rate ratio 0·34 [95% CI 0·14–0·79]; p=0·0081) and there were no differences regarding other serious adverse events.
Interpretation
This trial provides tentative evidence of the effectiveness and absence of safety concerns of the digital therapeutic, priovi, in the treatment of individuals with BPD.
COMMENT (NPW): To be labelled with the term 'borderline personality disorder' could be, for many if not most patients, worse than the disorder itself. It is hard to think of a more stigmatising diagnosis. Isn't it time that the global psychiatry community revisit this terminology?
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org