The BRIDGE project: a feasibility randomised controlled trial of brief, intensive assessment and integrated formulation for young people (age 14-24) with features of borderline personality disorder (Protocol)

Ruchika Gajwani; Fiona Sim; Kirsty McAllister; Helen Smith; Emma McIntosh; Paul Moran; Dennis Ougrin; Michael Smith; Andrew Ian Gumley; Andrew M Chanen; Helen Minnis

doi:10.3389/fpsyt.2024.1389578

The BRIDGE project: a feasibility randomised controlled trial of brief, intensive assessment and integrated formulation for young people (age 14-24) with features of borderline personality disorder (Protocol)

Front Psychiatry. 2024 Sep 24:15:1389578. doi: 10.3389/fpsyt.2024.1389578. eCollection 2024.

Authors

Ruchika Gajwani^{1

2}, Fiona Sim¹, Kirsty McAllister¹, Helen Smith³, Emma McIntosh¹, Paul Moran⁴, Dennis Ougrin⁵, Michael Smith^{1

2}, Andrew Ian Gumley^{1

2}, Andrew M Chanen^{6

7}, Helen Minnis^{1

2}

Affiliations

¹ School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
² National Health Service Greater Glasgow and Clyde, Glasgow, United Kingdom.
³ National Health Service (NHS) A&A, Ayrshire & Arran, Scotland, United Kingdom.
⁴ Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom.
⁵ Youth Resilience Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.
⁶ Orygen, Melbourne, VIC, Australia.
⁷ Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.

Abstract

Background: Borderline personality disorder (BPD) is a severe mental disorder that is characterised by a pervasive pattern of instability of interpersonal relationships, self-image, and mood as well as marked impulsivity. BPD has its peak incidence and prevalence from puberty through to emerging adulthood. BPD is a controversial diagnosis in young people. Commonly, young people with BPD are under-diagnosed, untreated, are not in employment or training and are estranged from their families. Yet, they have complex needs and are at high suicide risk.

Aim: To assess the feasibility of conducting a randomised controlled trial (f-RCT) of a BRIDGE, a brief intervention programme for young people (age 14-24) with BPD symptoms (sub-threshold or threshold) in a community sample from Scotland, UK.

Method: Forty young people (age 14-24) meeting criteria for BPD symptoms, will be randomised in a 1:1 ratio to receive either a) the BRIDGE intervention plus service-as-usual or b) service-as-usual alone. Follow up will be 12 weeks and 24 weeks post-intervention. The study is carried out between 2021 to 2024.

Outcome: The two primary outcomes of the MQ funded, BRIDGE project (f-RCT) are i. recruitment rates and ii. retention rates. The study will present the acceptability and appropriateness of our putative outcome measures for a future definitive randomised controlled trial (d-RCT).

Impact: Young people with BPD benefit from good clinical care and targeted intervention, however are regularly missed or mislabelled. The community based feasibility trial would provide initial evidence of variable needs of young people with complex needs, who maybe missed or excluded from services as they don't "fit" a model/diagnosis. Workable multi-agency service model proposed in the trial would be a major advance in understanding care pathways regardless of trial outcome.

Clinical trial registration: ClinicalTrial.gov, identifier NCT05023447.

Keywords: BPD features; Cognitive Analytic Therapy (CAT); borderline personality disorder (BPD); community intervention; early intervention; feasibility RCT (fRCT); young people.

Associated data

ClinicalTrials.gov/NCT05023447

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The clinical trial is funded by MQ as a clinical fellowship: Transforming Mental Health 2016 | Registered charity in England/Wales: 1139916 & Scotland: SCO46075 | Company number: 7406055. MQ have received funding for the project from two funders, the Rosetrees Trust (Registered with the Charity Commissions, No. 1197546) and a private family donation. The trial comes under the Research Governance sponsorship arrangements of NHS Greater Glasgow and Clyde with a shared ethics agreement with the University of Glasgow.