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Abstract Aim: First‐episode psychosis and borderline personality disorder are severe mental disorders that have their onset in youth. Their co‐occurrence is clinically well recognized, is associated with significant risks and is complex to treat. Yet, there is no published specific intervention for this problem. This study reports a pilot randomized controlled trial comparing combined specialist first‐episode treatment plus specialist early intervention for borderline personality, entitled Helping Young People Early, with specialist first‐episode treatment alone. We aimed to evaluate the safety and feasibility of adding early intervention for borderline personality. Methods: The study investigated the safety of specialist first‐episode treatment plus specialist early intervention for borderline personality in relation to deterioration in psychosis, aggression, self‐harm and suicidality, and feasibility in relation to the completion of therapy phases. Sixteen patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition‐Text Revision (DSM‐IV‐TR) criteria for first‐episode psychosis and borderline personality (four or more DSM‐IV criteria) were randomized either to specialist first‐episode treatment alone or specialist first‐episode treatment plus specialist early intervention for borderline personality and were followed up at the end of treatment and 6 months later. Results: The results showed that it was feasible to recruit and assess a high risk and complex group of patients who were agreeable to study participation. Specialist first‐episode treatment plus specialist early intervention for borderline personality was an acceptable and safe treatment. Conclusion: A larger‐scale randomized controlled trial of early intervention for borderline personality for young first‐episode psychosis patients with co‐occurring full or subsyndromal borderline personality is warranted.
Gleeson et al. (Wed,) studied this question.