Psychotherapies for borderline personality disorder: A focused systematic review and meta-Analysis

Research output: Contribution to journalReviewResearchpeer-review

Documents

  • Fulltext

    Final published version, 665 KB, PDF document

  • Jutta M. Stoffers-Winterling
  • Ole Jakob Storebø
  • Mickey T. Kongerslev
  • Erlend Faltinsen
  • Adan Todorovac
  • Mie Sedoc Jørgensen
  • Christian P. Sales
  • Henriette Edemann Callesen
  • Johanne Pereira Ribeiro
  • Birgit A. Völlm
  • Klaus Lieb
  • Simonsen, Erik

Background A recently updated Cochrane review supports the efficacy of psychotherapy for borderline personality disorder (BPD). Aims To evaluate the effects of standalone and add-on psychotherapeutic treatments more concisely. Method We applied the same methods as the 2020 Cochrane review, but focused on adult samples and comparisons of active treatments and unspecific control conditions. Standalone treatments (i.e. necessarily including individual psychotherapy as either the sole or one of several treatment components) and add-on interventions (i.e. complementing any ongoing individual BPD treatment) were analysed separately. Primary outcomes were BPD severity, self-harm, suicide-related outcomes and psychosocial functioning. Secondary outcomes were remaining BPD diagnostic criteria, depression and attrition. Results Thirty-one randomised controlled trials totalling 1870 participants were identified. Among standalone treatments, statistically significant effects of low overall certainty were observed for dialectical behaviour therapy (self-harm: standardised mean difference (SMD)-0.54, P = 0.006; psychosocial functioning: SMD-0.51, P = 0.01) and mentalisation-based treatment (self-harm: risk ratio 0.51, P < 0.0007; suicide-related outcomes: risk ratio 0.10, P < 0.0001). For adjunctive interventions, moderate-quality evidence of beneficial effects was observed for DBT skills training (BPD severity: SMD-0.66, P = 0.002; psychosocial functioning: SMD-0.45, P = 0.002), and statistically significant low-certainty evidence was observed for the emotion regulation group (BPD severity: mean difference-8.49, P < 0.00001), manual-Assisted cognitive therapy (self-harm: mean difference-3.03, P = 0.03; suicide-related outcomes: SMD-0.96, P = 0.005) and the systems training for emotional predictability and problem-solving (BPD severity: SMD-0.48, P = 0.002). Conclusions There is reasonable evidence to conclude that psychotherapeutic interventions are helpful for individuals with BPD. Replication studies are needed to enhance the certainty of findings.

Original languageEnglish
JournalBritish Journal of Psychiatry
Volume221
Issue number3
Pages (from-to)538–552
Number of pages15
ISSN0007-1250
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.

    Research areas

  • Borderline personality disorder, meta-Analysis, psychotherapy, systematic review, treatment

Number of downloads are based on statistics from Google Scholar and www.ku.dk


No data available

ID: 316672796