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Review: some evidence of benefit for psychotherapies in borderline personality disorder

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Question

Question: What are the effects of psychological interventions for borderline personality disorder (BPD)?

Outcomes: Overall BPD severity, BPD symptoms (DSM-IV criteria), psychopathology associated with, but not specific to, BPD, attrition from the study and adverse effects.

Methods

Design: Systematic review and meta-analysis.

Data sources: A comprehensive search of 15 databases was undertaken. See online notes for details.

Study selection and analysis: Randomised controlled trials (RCTs) comparing specific well-defined, theory-driven psychotherapeutic interventions against control interventions or other specific psychotherapeutic interventions in adults with BPD were included. Interventions were categorised as comprehensive psychotherapies if they included individual psychotherapy as a substantial part of the treatment programme, or as non-comprehensive if they did not.

Main results

Studies identified: Twenty-eight RCTs (n=1804) met the inclusion criteria. The comprehensive psychotherapies assessed by the trials included: dialectical behaviour therapy (DBT), mentalisation-based treatment in a partial hospitalisation setting (MBT-PH), outpatient MBT (MBT-out), transference-focused therapy (TFP), cognitive behavioural therapy (CBT), dynamic deconstructive psychotherapy (DDP), interpersonal psychotherapy (IPT), interpersonal therapy for BPD (IPT-BPD), client-centred therapy (CCT), schema-focused therapy (SFT) …

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