Psychotherapies for borderline personality disorder:A focused systematic review and meta-Analysis
| Autor: | 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, Erik Simonsen |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Adult
Cognitive Behavioral Therapy treatment 610 Medizin Dialectical Behavior Therapy Psychotherapy psychotherapy Psychiatry and Mental health systematic review Borderline Personality Disorder Borderline personality disorder 150 Psychologie 610 Medical sciences Humans 150 Psychology Self-Injurious Behavior meta-Analysis Randomized Controlled Trials as Topic |
| Zdroj: | Stoffers-Winterling, J M, Storebø, O J, Kongerslev, M T, Faltinsen, E, Todorovac, A, Jørgensen, M S, Sales, C P, Callesen, H E, Ribeiro, J P, Völlm, B A, Lieb, K & Simonsen, E 2022, ' Psychotherapies for borderline personality disorder : A focused systematic review and meta-Analysis ', British Journal of Psychiatry, vol. 221, no. 3, pp. 538–552 . https://doi.org/10.1192/bjp.2021.204 |
| ISSN: | 0007-1250 |
| DOI: | 10.1192/bjp.2021.204 |
| Popis: | BackgroundA recently updated Cochrane review supports the efficacy of psychotherapy for borderline personality disorder (BPD).AimsTo evaluate the effects of standalone and add-on psychotherapeutic treatments more concisely.MethodWe 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.ResultsThirty-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).ConclusionsThere is reasonable evidence to conclude that psychotherapeutic interventions are helpful for individuals with BPD. Replication studies are needed to enhance the certainty of findings. |
| Databáze: | OpenAIRE |
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