Question:
In adults with borderline personality disorder, which is the most effective psychological intervention (excluding CBT and DBT), in improving patient outcomes?
Answer:
Data from RCTs suggest that psychotherapies are effective in
treatment patients with BPD, but there is insufficient evidence to
determine which psychological intervention (excluding CBT and DBT)
is the most effective in improving patient outcomes. Most
treatments were only evaluated in single studies, and there are
some concerns regarding the risk of bias in these studies. There
are very few direct comparisons of different treatments. Data from
single studies support the effectiveness of mentalisation-based
treatment in a partial hospitalisation setting (MBT-PH), outpatient
MBT (MBT-out), transference-focused therapy (TFP), interpersonal
therapy for BPD (IPT-BPD), psychic representation focused
psychotherapy (PRFP), emotion regulation group therapy (ERG),
schema-focused group therapy (SFT-G), systems training for
emotional predictability and problem solving for borderline
personality disorder (STEPPS), STEPPS plus individual therapy
(STEPPS+IT), manual-assisted cognitive treatment (MACT) and
psychoeducation (PE). There was no RCT evidence on cognitive
analytical therapy (CAT). Interpersonal psychotherapy was only
effective in the treatment of associated depression. No
statistically significant effects were found for DDP interventions.
Direct comparisons suggest that DBT may be more effective than CCT
and SFT more effective than TFP. There is a need for further high
quality studies providing direct comparisons of the different
available psychological treatments for patients with BPD.