Out-patient psychotherapy for borderline personality disorder: cost-effectiveness of schema-focused therapy v. transference-focused psychotherapy.

A.D.I. van Asselt*, C.D. Dirksen, A.R. Arntz, J.H Giesen-Bloo, R. van Dyck, P. Spinhoven, W. van Tilburg, I. Kremers, M. Nadort, J.L. Severens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background Schema-focused therapy (SFT) and transference-focused psychotherapy (TFP) for borderline personality disorder were recently compared in a randomised multicentre trial. Aims To assess the societal cost-effectiveness of SFT v. TFP in treating borderline personality disorder. Method Costs were assessed by interview. Health-related quality of life was measured using EQ-5D. Outcomes were costs per recovered patient (recovery assessed with the Borderline Personality Disorder Severity index) and costs per quality-adjusted life-year (QALY). Results Mean 4-year bootstrapped costs were (SIC)37 826 for SFT and (SIC)46 795 for TFP (95% uncertainty interval for difference -21 775 to 3546); QALYs were 2.15 for SFT and 2.27 for TFP (95% UI -0.51 to 0.28). The percentages of patients who recovered were 52% and 29% respectively. The SFT intervention was less costly and more effective than TFP (dominant), for recovery; it saved (SIC)90 457 for one QALY loss. Conclusions Despite the initial slight disadvantage in QALYs, there is a high probability that compared with TFP, SFT is a cost-effective treatment for borderline personality disorder.
Original languageEnglish
Pages (from-to)450-457
JournalBritish Journal of Psychiatry
Issue number6
Publication statusPublished - 1 Jan 2008

Cite this