Patients with Borderline Personality Disorder Not Participating in an RCT: Are They Different?

Background: Despite the notion that randomized controlled trials
are regarded as the gold standard in psychotherapy research,
questions about their generalizability have been raised. This paper
focuses on the differences between participants and eligible
nonparticipants of a randomized controlled trial for patients with
borderline personality disorder (BPD). Sampling and Methods: One
hundred forty-two patients were screened, and 122 were found
eligible for study participation. Out of these, 64 patients (52.5%)
gave informed consent and were included in the study. Results: The
58 eligible nonparticipants showed a lower level of functioning
(global assessment of functioning score), had a history of more
outpatient treatment attempts and were living alone more often.
Regarding acute symptoms and severity of BPD as indexed by suicide
attempts, inpatient treatments, substance abuse and history of
trauma, no differences between the groups could be detected.
Moreover, participants showed significantly more eating disorders,
whereas nonparticipants presented more affective and anxiety
disorders. Conclusions: The results indicate that lower
psychosocial functioning and comorbid affective and anxiety
disorders decrease BPD patients' willingness to participate in an
RCT. Copyright (C) 2010 S. Karger AG, Basel