TY - JOUR

T1 - Perinatal emotional skills groups for women and birthing people with borderline personality disorder

T2 - outcomes from a feasibility randomised controlled trial

AU - Moran, Paul

AU - Bick, Debra

AU - Biddle, Lucy

AU - Borries, Belinda

AU - Kandiyali, Rebecca

AU - Mgaieth, Farah

AU - Patel, Vivan

AU - Rigby, Janice

AU - Seume, Penny

AU - Sadhnani, Vaneeta

AU - Smith, Nadine

AU - Swales, Michaela

AU - Turner, Nicholas

PY - 2025/1/1

Y1 - 2025/1/1

N2 - BACKGROUND: There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested.AIMS: To test the feasibility of conducting a randomised controlled trial (RCT) of perinatal ESGs for women and birthing people with BPD.METHOD: Two-arm parallel-group feasibility RCT. We recruited people from two centres, aged over 18 years, meeting DSM-5 diagnostic criteria for BPD, who were pregnant or within 12 months of a live birth. Eligible individuals were randomly allocated on a 1:1 ratio to ESGs + treatment as usual (TAU), or to TAU. Outcomes were assessed at 4 months post randomisation.RESULTS: A total of 100% of the pre-specified sample (n = 48) was recruited over 6 months, and we obtained 4-month outcome data on 92% of randomised participants. In all, 54% of participants allocated to perinatal ESGs attended 75% of the full group treatment (median number of sessions: 9 (interquartile range 6-11). At 4 months, levels of BPD symptoms (adjusted coefficient -2.0, 95% CI -6.2 to 2.1) and emotional distress (-2.4, 95% CI -6.2 to 1.5) were lower among those allocated to perinatal ESGs. The directionality of effect on well-being and social functioning also favoured the intervention. The cost of delivering perinatal ESGs was estimated to be £918 per person.CONCLUSIONS: Perinatal ESGs may represent an effective intervention for perinatal women and birthing people with BPD. Their efficacy should be tested in a fully powered RCT, and this is a feasible undertaking.TRIAL REGISTRATION: ISRCTN80470632.

AB - BACKGROUND: There is no clear evidence about how to support people with borderline personality disorder (BPD) during the perinatal period. Perinatal emotional skills groups (ESGs) may be helpful, but their efficacy has not been tested.AIMS: To test the feasibility of conducting a randomised controlled trial (RCT) of perinatal ESGs for women and birthing people with BPD.METHOD: Two-arm parallel-group feasibility RCT. We recruited people from two centres, aged over 18 years, meeting DSM-5 diagnostic criteria for BPD, who were pregnant or within 12 months of a live birth. Eligible individuals were randomly allocated on a 1:1 ratio to ESGs + treatment as usual (TAU), or to TAU. Outcomes were assessed at 4 months post randomisation.RESULTS: A total of 100% of the pre-specified sample (n = 48) was recruited over 6 months, and we obtained 4-month outcome data on 92% of randomised participants. In all, 54% of participants allocated to perinatal ESGs attended 75% of the full group treatment (median number of sessions: 9 (interquartile range 6-11). At 4 months, levels of BPD symptoms (adjusted coefficient -2.0, 95% CI -6.2 to 2.1) and emotional distress (-2.4, 95% CI -6.2 to 1.5) were lower among those allocated to perinatal ESGs. The directionality of effect on well-being and social functioning also favoured the intervention. The cost of delivering perinatal ESGs was estimated to be £918 per person.CONCLUSIONS: Perinatal ESGs may represent an effective intervention for perinatal women and birthing people with BPD. Their efficacy should be tested in a fully powered RCT, and this is a feasible undertaking.TRIAL REGISTRATION: ISRCTN80470632.

U2 - 10.1192/bjo.2024.833

DO - 10.1192/bjo.2024.833

M3 - Article

C2 - 39721952

VL - 11

SP - e12

JO - BJPsych open

JF - BJPsych open

SN - 2056-4724

IS - 1

ER -