***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Little is known about the influence of depressed patients ’ preferences and expectations about treatments upon treatment outcome . We investigated whether better clinical outcome in depressed primary care patients is associated with receiving their preferred treatment . Methods : Within a r and omized placebo-controlled single-centre 10-week trial with 5 arms ( sertraline ; placebo ; cognitive-behavioral group therapy , CBT-G ; moderated self-help group control ; treatment with sertraline or CBT-G according to patients ’ choice ) , outcomes for 145 primary care patients with mild-to-moderate depressive disorders according to DSM-IV criteria were investigated . Preference for medication versus psychotherapy was assessed at screening using a single item . Post-baseline difference scores for the Hamilton Depression Rating Scale ( HAMD-17 ) were used to assess treatment outcome ( mixed-model repeated- measures regression analysis ) . Results : Depressed patients receiving their preferred treatment ( n = 63 ) , whether sertraline or CBT-G , responded significantly better than those who did not receive their preferred therapy ( n = 54 ; p = 0.001 ) . The difference in outcome between both groups was 8.0 points on the HAMD-17 for psychotherapy and 2.9 points on the HAMD-17 for treatment with antidepressants . Results were not explained by differences in depression severity or dropout rates . Conclusions : Patients ’ relative preference for medication versus psychotherapy should be considered when offering a treatment because receiving the preferred treatment conveys an additional and clinical ly relevant benefit ( HAMD-17 : + 2.9 points for drugs ; + 8.0 points for CBT-G ) in outcome This study tests the effectiveness of adding an eight-month , thirty-session schema-focused therapy ( SFT ) group to treatment-as-usual ( TAU ) individual psychotherapy for borderline personality disorder ( BPD ) . Patients ( N=32 ) were r and omly assigned to  SFT-TAU and TAU alone . Dropout was 0 % SFT , 25 % TAU . Significant reductions in BPD symptoms and global severity of psychiatric symptoms , and improved global functioning with large treatment effect sizes were found in the SFT-TAU group . At the end of treatment , 94 % of SFT-TAU compared to 16 % of TAU no longer met BPD diagnosis criteria ( p<.001 ) . This study supports group SFT as an effective treatment for BPD that leads to recovery and improved overall functioning Dialectical behavior therapy for posttraumatic stress disorder ( DBT-PTSD ) is tailored for adults with PTSD from childhood sexual abuse ( CSA ) . It uses principles from DBT and trauma-focused cognitive-behavioral approaches . To evaluate acceptance and safety , the authors treated 29 women with chronic CSA-related PTSD plus at least one other comorbid diagnosis . The Posttraumatic Diagnostic Scale ( PDS ) , Symptom Checklist 90-Revised , Beck Depression Inventory , and State Trait Anxiety Inventory were administered prior to , at the end of , and 6 weeks after 3 months of intensive residential treatment . An effect size of 1.22 on the PDS was found between baseline and follow-up . Effect sizes for secondary outcomes ranged from medium to large . The results suggest that DBT-PTSD has promise for reducing severe and chronic PTSD after CSA OBJECTIVE This study aim ed to evaluate the success of implementing outpatient schema focused therapy ( ST ) for borderline patients in regular mental healthcare and to determine the added value of therapist telephone availability outside office hours in case of crisis ( TTA ) . METHODS To enhance the implementation , the following adaptations regarding the original ST protocol were applied : a reduction in the frequency and duration of the therapy ; training therapists of eight regular healthcare centers in ST with a structured and piloted program supported by a set of films ( DVDs ) with examples of ST techniques ; training and supervision given by Dutch experts . Telephone availability outside office hours was r and omly allocated to 50 % of the therapists of each treatment center . Patient 's outcome measures were assessed with a semi-structured interview and self-report measures on BPD , quality of life , general psychopathology and an ST question naire , before , during and after treatment . RESULTS Data on 62 DSM-IV defined BPD patients were available . Intention-to-treat analyses showed that after 1.5 years of ST 42 % of the patients had recovered from BPD . No added value of therapist telephone availability ( TTA ) was found on the BPDSI score nor on any other measure after 1.5 years of ST . CONCLUSIONS ST for BPD can be successfully implemented in regular mental healthcare . Treatment results and dropout were comparable to a previous clinical trail . No additional effect of extra crisis support with TTA outside office hours ST was found BACKGROUND Transference-focused psychotherapy is a manualised treatment for borderline personality disorder . AIMS To compare transference-focused psychotherapy with treatment by experienced community psychotherapists . METHOD In a r and omised controlled trial ( NCT00714311 ) 104 female out- patients were treated for 1 year with either transference-focused psychotherapy or by an experienced community psychotherapist . RESULTS Significantly fewer participants dropped out of the transference-focused psychotherapy group ( 38.5 % v. 67.3 % ) and also significantly fewer attempted suicide ( d = 0.8 , P = 0.009 ) . Transference-focused psychotherapy was significantly superior in the domains of borderline symptomatology ( d = 1.6 , P = 0.001 ) , psychosocial functioning ( d = 1.0 , P = 0.002 ) , personality organisation ( d = 1.0 , P = 0.001 ) and psychiatric in-patient admissions ( d = 0.5 , P = 0.001 ) . Both groups improved significantly in the domains of depression and anxiety and the transference-focused psychotherapy group in general psychopathology , all without significant group differences ( d = 0.3 - 0.5 ) . Self-harming behaviour did not change in either group . CONCLUSIONS Transference-focused psychotherapy is more efficacious than treatment by experienced community psychotherapists in the domains of borderline symptomatology , psychosocial functioning , and personality organisation . Moreover , there is preliminary evidence for a superiority in the reduction of suicidality and need for psychiatric in-patient treatment Background Experimenter ’s allegiance ( EA ) refers to a personal confidence of the superiority of a specific psychotherapy treatment . This factor has been linked with larger treatment effects in favor of the preferred treatment . However , various studies have displayed contradictory results between EA and the pattern of treatment effects . Aims Using a systematic approach followed by meta- analysis , we aim ed to evaluate the impact of an allegiance effect on the results of psychotherapeutic studies . Method We considered the meta-analyses of r and omized controlled trials ( RCTs ) of different types of psychotherapies in the Cochrane Data base of Systematic Review s. Eligible articles included meta-analyses of RCTs with at least one study showing evidence of EA ( i.e. , allegiant study ) . Effect sizes in allegiant RCTs were compared with non-allegiant using r and om and fixed models and a summary relative odds ratio ( ROR ) were calculated . Heterogeneity was quantified with the I2 metric . Results A total of 30 meta-analyses including 240 RCTs were analyzed . The summary ROR was 1.31 [ ( 95 % confidence interval ( CI : 1.03–1.66 ) P = 0.30 , I2 = 53 % ] indicating larger effects when allegiance exists . The impact of allegiance did not differ significantly ( P > 0.05 ) when we compared psychiatric versus medical outcomes . Allegiance effect was significant for all forms of psychotherapy except for cognitive behavioral therapy . Moreover , the impact of allegiance was significant only when the treatment integrity of delivered psychotherapy was not assessed . Allegiance effect was even stronger where the experimenter was also both the developer of the preferred treatment and supervised or trained the therapists . No significant differences were found between allegiant and non-allegiant studies in terms of overall quality of studies . Conclusions Experimenter ’s allegiance influences the effect sizes of psychotherapy RCTs and can be considered non-financial conflict of interest introducing a form of optimism bias , especially since blinding is problematic in this kind of research . A clear reporting of EA in every single study should be given an opportunity to investigators of minimizing its overestimation effects OBJECTIVE Prospect i ve registration increases the validity of r and omized controlled trials ( RCTs ) . In the United States , registration is a legal requirement for drugs and devices regulated by the Food and Drug Administration ( FDA ) , and many biomedical journals refuse to publish trials that are not registered . Trials in clinical psychology have not been subject to these requirements ; it is unknown to what extent they are registered . METHOD We search ed the 25 highest-impact clinical psychology journals that published at least 1 RCT of a health-related psychological intervention in 2013 . For included trials , we evaluated their registration status ( prospect i ve , retrospective , not registered ) and the completeness of their outcome definitions . RESULTS We identified 163 articles that reported 165 RCTs ; 73 ( 44 % ) RCTs were registered , of which only 25 ( 15 % ) were registered prospect ively . Of registered RCTs , only 42 ( 58 % ) indicated their registration status in the publication . Only 2 ( 1 % of all trials ) were registered prospect ively and defined their primary outcomes completely . For the primary outcome ( s ) , 72 ( 99 % ) of all registration s defined the domain , 67 ( 92 % ) the time frame , and 48 ( 66 % ) the specific measurements . Only 19 ( 26 % ) and 5 ( 7 % ) defined the specific metric and method of aggregation , respectively , for all primary outcomes . CONCLUSIONS Very few reports of RCTs published in clinical psychology journals were registered prospect ively and completely . Clinical psychology journals could improve transparency and reproducibility , as well as reduce bias , by requiring complete prospect i ve trial registration for publication and by including trial registration numbers in all reports of RCTs . ( PsycINFO Data base OBJECTIVE This study evaluates the efficacy of integrating PTSD treatment into Dialectical Behavior Therapy ( DBT ) for women with borderline personality disorder , PTSD , and intentional self-injury . METHODS Participants were r and omized to DBT ( n=9 ) or DBT with the DBT Prolonged Exposure ( DBT PE ) protocol ( n=17 ) and assessed at 4-month intervals during the treatment year and 3-months post-treatment . RESULTS Treatment expectancies , satisfaction , and completion did not differ by condition . In DBT+DBT PE , the DBT PE protocol was feasible to implement for a majority of treatment completers . Compared to DBT , DBT+DBT PE led to larger and more stable improvements in PTSD and doubled the remission rate among treatment completers ( 80 % vs. 40 % ) . Patients who completed the DBT PE protocol were 2.4 times less likely to attempt suicide and 1.5 times less likely to self-injure than those in DBT . Among treatment completers , moderate to large effect sizes favored DBT+DBT PE  for dissociation , trauma-related guilt cognitions , shame , anxiety , depression , and global functioning . CONCLUSIONS DBT with the DBT PE protocol is feasible , acceptable , and safe to administer , and may lead to larger improvements in PTSD , intentional self-injury , and other outcomes than DBT alone . The findings require replication in a larger sample OBJECTIVE The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management , including a combination of psychodynamically informed therapy and symptom-targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder . METHOD This was a single-blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self-injurious episodes in the past 5 years were r and omly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management . The primary outcome measures , assessed at baseline and every 4 months over the treatment period , were frequency and severity of suicidal and nonsuicidal self-harm episodes . RESULTS Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment , including significant reductions in the frequency and severity of suicidal and nonsuicidal self-injurious episodes and significant improvements in most secondary clinical outcomes . Both groups had a reduction in general health care utilization , including emergency visits and psychiatric hospital days , as well as significant improvements in borderline personality disorder symptoms , symptom distress , depression , anger , and interpersonal functioning . No significant differences across any outcomes were found between groups . CONCLUSIONS These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well-specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder IMPORTANCE Dialectical behavior therapy ( DBT ) is an empirically supported treatment for suicidal individuals . However , DBT consists of multiple components , including individual therapy , skills training , telephone coaching , and a therapist consultation team , and little is known about which components are needed to achieve positive outcomes . OBJECTIVE To evaluate the importance of the skills training component of DBT by comparing skills training plus case management ( DBT-S ) , DBT individual therapy plus activities group ( DBT-I ) , and st and ard DBT which includes skills training and individual therapy . DESIGN , SETTING , AND PARTICIPANTS We performed a single-blind r and omized clinical trial from April 2 
    Output:
    
Conclusion : There is moderate quality evidence that specialized psychotherapies are effective in reducing overall borderline personality disorder severity .