Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
| Autor: | José Arzola Ruiz, Georgina Guilera, Arturo Bados, Irene Alvarez-Tomás |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Remission Spontaneous MEDLINE Scopus PsycINFO 03 medical and health sciences 0302 clinical medicine Behavior Therapy Borderline Personality Disorder medicine Humans Prospective Studies Prospective cohort study Borderline personality disorder Depression (differential diagnoses) business.industry Depression Age Factors medicine.disease 030227 psychiatry Psychiatry and Mental health Suicide Meta-analysis Disease Progression Observational study Female Trastorns límits de la personalitat business 030217 neurology & neurosurgery Metaanàlisi Follow-Up Studies |
| Zdroj: | Dipòsit Digital de la UB Universidad de Barcelona |
| ISSN: | 0924-9338 |
| Popis: | Background:This meta-analytic review is the first to synthesise findings from prospective research on the long-term course of borderline personality disorder in adult clinical populations.Methods:Systematic searches were conducted in Medline, PsycINFO, PsycArticles, PubMed and Scopus within the period 1990-2017. Inclusion criteria were: (1) adult BPD sample diagnosed by a validated, semi-structured interview; (2) at least two prospective assessments of outcomes; and (3) follow-up period ≥ 5 years. Quality of evidence was rated with the Systematic Assessment of Quality in Observational Research (SAQOR). Four outcomes were meta-analysed using mixed-effect methods: remission from BPD diagnosis, completed suicide, depressive symptoms, and functioning. Potential moderators regarding the natural course and the initial treatment received were studied.Results:Eleven studies met the inclusion criteria, with 837 participants from nine countries being followed. Between 50% and 70% of the BPD patients achieved remission in the long-term. Significant reductions in depression and functional impairment were also found. Mean suicide rate ranged from 2% to 5%. Younger age was associated with higher likelihood for remission. Being female was correlated with lower functional improvement. Despite some positive trends, there were no significant associations between treatment moderators and the long-term outcome.Conclusions:Findings suggest that the course of BPD is characterised by symptomatic amelioration and a slight functional improvement in the long-term. Age and gender modulate the long-term prognosis and should be considered to adapt treatment resources. Further research is required to draw robust conclusions on the long-term effects of psychotherapeutic interventions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|