Stationäre und teilstationäre DBT-Angebote für Patienten mit Borderline-Persönlichkeitsstörung - Ergebnisse einer deutschlandweiten Umfrage

Background: Retrospective survey on the Dialectical Behavior Therapy (DBT) supply for patients with Borderline Personality Disorder (BPD) in Germany in 2011 regarding number of treatment capacities; patients per year; mean waiting time; treatment duration; subspecialization; contingent of inpatient, day clinic or outpatient treatment. Methods: Using the email distributor of the German DBT network, a survey was carried out by questionnaire addressing inpatient facilities and day hospitals. Results: 42 hospitals and day clinics answered (75% of contacted facilities, offering 527 therapy slots for 2,310 patients per year). 14.3 weeks was the mean waiting time for inpatient or day hospital DBT. Mean treatment duration was >= 9.6 and <= 20.3 weeks. 52.2% of the responding facilities declared to be certified by the network (only 7.1% of day clinics). 57.1% offered a subspecialization, 14.3% separated diagnostic and treatment phase, 92.1% regarded a day clinic offer as desirable, although only 28.6% offered it. 38.1% offered a switch between inpatient, day hospital, or outpatient treatment (this came along with a change of therapist in 61%). Only 4.8% had special terms of contract with health insurance providers to account for higher treatment costs associated with DBT. Conclusions: This article is based on a first systematic survey in Germany. Extrapolated, in 2011 there were 700 inpatient or day hospitals in Germany offering DBT treatment for ca. 3,000 BPD patients. This approximates a ratio of 191 patients for one existing DBT hospital or day clinic unit per year. This reflects the great demand for this treatment and could be interpreted as an imbalance between supply and demand - in addition to a gap in outpatient care.