Borderline Personality Disorder (BPD) is the most common personality disorder in clinical populations. It is a complex and debilitating condition characterized by severe instability and interpersonal problems.
According to data, more than 75% of people with BPD have committed some type of self-harm and suicide rates are estimated between 8 and 10%, which translates into a risk 50 times higher than that of the general population.
Specially designed treatments for BPD, such as DBT and some psychodynamic treatments such as Mentalization-Based Therapy or Transference-Focused Psychotherapy, have shown promising results.
In general these treatments seem to be more effective than the usual psychological treatments. However, most of the studies that tested these treatments were developed by their own authors. Or their results have reported moderate effects on core symptoms, self-harm and suicide attempts.
To clarify the effects of these therapies, Ioana A. Cristea and an international team of researchers carried out a and published The JAMA Network.
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In total, 33 randomized studies were included, involving 1169 participants and 1087 people in the control group. The evaluation group included subjects diagnosed with a standardized clinical interview, subjects diagnosed with a recent episode of self-harm, and a special sample that included people with BPD and addiction problems or some unusual characteristic.
The outcomes (characteristic symptoms, suicide attempts, and suicides) of therapies designed for BPD were compared with other therapies that were not specifically created for this disorder.
Analyzes found that therapies specially designed for BPD were more effective than traditional treatments. Especially Dialectical Behavioral Therapy and psychodynamic therapies. However, the advantage was not much greater and no significant differences were found between the different types of psychotherapies. Most of the research was on Dialectical Behavioral Therapy and Psychodynamic Psychotherapies, which may have generated a small, but significant, effect between the groups. Another discovery was that Cognitive Behavioral Therapy was not superior to the control group treatments. Although it must be clarified that there were only five studies on CBT, which could also affect its scope.
Cristea and his team explain that the effectiveness of these treatments is small and the advantage of treatments designed for BPD could benefit from publication biases in their favor and also from the difficulty encountered in following up participants.
Responding to the title of the article is not an easy task. For now we must answer that DBT and some psychodynamic therapies seem to be the most effective, but more data is needed to corroborate this.
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