Cochrane · systematic review · CD005652
Psychological therapies for people with borderline personality disorder
Stoffers-Winterling, JM, Völlm, BA, Rücker, G, et al. · Cochrane Database of Systematic Reviews · 2012 · Cochrane Library
Developmental, Psychosocial and Learning ProblemsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
71
current version
GRADE rated
71
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 52 · 73.2%Moderate 19 · 26.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Dialectical Behaviour Therapy (DBT) versus treatment as usual (TAU) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severity ‐ DBT vs. TAUmean number of BPD criteria met Dialectical Behaviour Therapy (DBT) vs treatment | no estimate extracted | 1 study · 20 participants | Low Downgraded: imprecision |
Inappropriate anger ‐ DBT vs. TAUSTAXI2 anger out, STAXI anger trait Dialectical Behaviour Therapy (DBT) vs treatment | no estimate extracted | 2 studies · 46 participants | Low Downgraded: imprecision |
Impulsivity ‐ DBT vs. TAUBPDSI‐IV3 Dialectical Behaviour Therapy (DBT) vs treatment | no estimate extracted | 1 study · 48 participants | Low Downgraded: imprecision |
Suicidality ‐ DBT vs. TAUBSS4 Dialectical Behaviour Therapy (DBT) vs treatment | no estimate extracted | 1 study · 20 participants | Low Downgraded: imprecision |
Parasuicidality ‐ DBT vs. TAUacts of self‐mutilation Dialectical Behaviour Therapy (DBT) vs treatment | no estimate extracted | 3 studies · 110 participants | Moderate Downgraded: imprecision |
parasuicidality ‐ DBT vs. TAU acts of self‐mutilation Dialectical Behaviour Therapy (DBT) vs treatment | RR 1.11 [0.78, 1.57] | 1 study · 51 participants | Low Downgraded: imprecision |
Interpersonal problems ‐ DBT vs. TAUWHOQOL‐Bref6‐social relationships multiplied by (‐1) Dialectical Behaviour Therapy (DBT) vs treatment | no estimate extracted | 1 study · 48 participants | Low Downgraded: imprecision |
Dissociation/psychoticism ‐ DBT vs. TAUDES7 Dialectical Behaviour Therapy (DBT) vs treatment | no estimate extracted | 1 study · 20 participants | Low Downgraded: imprecision |
Dialectical Behaviour Therapy (DBT) versus general management (GM) according to APA guidelines for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityZAN‐BPD1 total Dialectical Behaviour Therapy (DBT) vs general management (GM) according to APA guidelines | no estimate extracted | 1 study · 180 participants | Moderate Downgraded: imprecision |
Inappropriate anger ‐ DBT vs. GMSTAXI3‐anger out Dialectical Behaviour Therapy (DBT) vs general management (GM) according to APA guidelines | no estimate extracted | 1 study · 180 participants | Moderate Downgraded: imprecision |
Parasuicidality ‐ DBT vs. GMmean no. of suicidal and self‐injurious episodes Dialectical Behaviour Therapy (DBT) vs general management (GM) according to APA guidelines | no estimate extracted | 1 study · 180 participants | Moderate Downgraded: imprecision |
Interpersonal problems ‐ DBT vs. GMIIP‐C4 total Dialectical Behaviour Therapy (DBT) vs general management (GM) according to APA guidelines | no estimate extracted | 1 study · 180 participants | Moderate Downgraded: imprecision |
Dialectical Behaviour Therapy (DBT) versus community treatment by experts (CTBE) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
SuicidalitySBQ1 Dialectical Behaviour Therapy (DBT) vs community treatment by experts (CTBE) | no estimate extracted | 1 study · 89 participants | Low Downgraded: imprecision |
Dialectical Behaviour Therapy for BPD with post‐traumatic stress disorder (DBT‐PTSD) versus waiting list (WL) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityBSL1 Dialectical Behaviour Therapy for BPD with post‐traumatic stress disorder (DBT‐PTSD) vs waiting list (WL) | no estimate extracted | 1 study · 31 participants | Low Downgraded: imprecision |
DissociationDES3 Dialectical Behaviour Therapy for BPD with post‐traumatic stress disorder (DBT‐PTSD) vs waiting list (WL) | no estimate extracted | 1 study · 30 participants | Low Downgraded: imprecision |
Mentalisation‐Based Treatment‐partial hospitalisation (MBT‐PH) versus treatment as usual (TAU) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Suicidalityno. of participants with suicide attempt (last 6 months) Mentalisation‐Based Treatment‐partial hospitalisation (MBT‐PH) vs treatment | RR 0.08 [0.01, 0.58] | 1 study · 38 participants | Low Downgraded: imprecision |
Parasuicidalityno. of participants with self‐mutilating behaviour (last 6 months) Mentalisation‐Based Treatment‐partial hospitalisation (MBT‐PH) vs treatment | RR 0.44 [0.24, 0.81] | 1 study · 38 participants | Low Downgraded: imprecision |
Interpersonal problemsIIP2 Mentalisation‐Based Treatment‐partial hospitalisation (MBT‐PH) vs treatment | no estimate extracted | 1 study · 38 participants | Low Downgraded: imprecision |
Mentalisation‐Based Treatment‐outpatient (MBT‐out) versus treatment as usual (TAU) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Suicidalityno. of participants with life‐threatening suicide attempts (last 6 months) Mentalisation‐Based Treatment‐outpatient (MBT‐out) vs treatment | RR 0.11 [0.03, 0.46] | 1 study · 134 participants | Moderate Downgraded: imprecision |
Parasuicidalityno. of participants with self‐harm incidents (last 6 months) Mentalisation‐Based Treatment‐outpatient (MBT‐out) vs treatment | RR 0.56 [0.34, 0.92] | 1 study · 134 participants | Moderate Downgraded: imprecision |
Interpersonal problemsIIP2 Mentalisation‐Based Treatment‐outpatient (MBT‐out) vs treatment | no estimate extracted | 1 study · 134 participants | Moderate Downgraded: imprecision |
Transference‐Focused Psychotherapy (TFP) versus community treatment by experts (CTBE) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severitymean number of BPD criteria met. Scale from: 0 to 9. Transference‐Focused Psychotherapy (TFP) vs community treatment by experts (CTBE) | no estimate extracted | 1 study · 104 participants | Moderate Downgraded: imprecision |
Suicidalityno. of participants with suicidal act (last 12 months) Transference‐Focused Psychotherapy (TFP) vs community treatment by experts (CTBE) | RR 0.64 [0.27, 1.51] | 1 study · 104 participants | Moderate Downgraded: imprecision |
Parasuicidalityno. of participants with self‐harming behaviour (last 12 months) Transference‐Focused Psychotherapy (TFP) vs community treatment by experts (CTBE) | RR 1.09 [0.84, 1.4] | 1 study · 104 participants | Moderate Downgraded: imprecision |
Cognitive‐Behavioural Therapy (CBT) versus treatment as usual (TAU) for borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Suicidality ‐ CBT vs. TAUno. of participants with suicidal act (last 12 months) Cognitive‐Behavioural Therapy (CBT) vs treatment | RR 0.78 [0.47, 1.27] | 1 study · 101 participants | Moderate Downgraded: imprecision |
Parasuicidality ‐ CBT vs. TAUno. of participants with self‐harming behaviour (last 12 months) Cognitive‐Behavioural Therapy (CBT) vs treatment | RR 1.17 [0.86, 1.6] | 1 study · 99 participants | Moderate Downgraded: imprecision |
Interpersonal problems scoreIIP‐SC2 Cognitive‐Behavioural Therapy (CBT) vs treatment | no estimate extracted | 1 study · 99 participants | Moderate Downgraded: imprecision |
Dynamic‐Deconstructive Psychotherapy (DDP) versus treatment as ususal (TAU) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityBEST1 Dynamic‐Deconstructive Psychotherapy (DDP) vs treatment | no estimate extracted | 1 study · 30 participants | Low |
Parasuicidalityno. of participants with parasuicide (last 3 months) Dynamic‐Deconstructive Psychotherapy (DDP) vs treatment | RR 0.89 [0.47, 1.67] | 1 study · 30 participants | Low |
DissociationDES3 Dynamic‐Deconstructive Psychotherapy (DDP) vs treatment | no estimate extracted | 1 study · 30 participants | Low |
Interpersonal Psychotherapy (IPT) versus clinical management (CM) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
No primary outcomes available Interpersonal Psychotherapy (IPT) vs clinical management (CM) | no estimate extracted | 1 study · 39 participants | Low |
Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) versus clinical management (CM) for people with borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityBPDSI‐IV1‐total score Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
AngerBPDSI‐IV1‐anger Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
Affective instabilityBPDSI‐IV1‐affective instability Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
Chronic feelings of emptinessBPDSI‐IV1‐emptiness Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
ImpulsivityBPDSI‐IV1‐impulsivity Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
ParasuicidalityBPDSI‐IV1‐parasuicidal behaviour Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
Interpersonal problemsBPDSI‐IV1‐interpersonal relationships Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
Avoidance of abandonment BPDSI‐IV1‐abandonment Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
Identity disturbance BPDSI‐IV1‐identity disturbance Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
Dissociation/paranoid ideation BPDSI‐IV1‐paranoid ideation Interpersonal Psychotherapy adapted for BPD (IPT‐BPD) vs clinical management (CM) | no estimate extracted | 1 study · 44 participants | Low Downgraded: imprecision |
Dialectical Behaviour Therapy‐skills training only (DBT‐ST)versus standard group (SG) for borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityCGI‐BPD1‐global | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
AngerCGI‐BPD1‐anger | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
Affective instabilityCGI‐BPD1‐affective instability | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
Chronic feelings of emptinessCGI‐BPD1‐emptiness | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
ImpulsivityCGI‐BPD1‐impulsivity | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
SuicidalityCGI‐BPD1‐suicidality | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
Interpersonal problemsCGI‐BPD1‐unstable relationships | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
Dissociation/psychoticismBPRS3 | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision |
Emotion regulation group training (ERG) versus treatment as usual (TAU) for borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityBEST1 Emotion regulation group training (ERG) vs treatment | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision |
Affective instabilityDERS3‐emotional dysregulation Emotion regulation group training (ERG) vs treatment | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision |
ImpulsivityDERS3‐impulse dyscontrol Emotion regulation group training (ERG) vs treatment | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision |
ParasuicidalityDERS3‐self‐harm frequency (transformed) Emotion regulation group training (ERG) vs treatment | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision |
Schema‐Focused Therapy‐Group (SFT‐G) versus treatment as usual (TAU) for borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityBSI1 Schema‐Focused Therapy‐Group (SFT‐G) vs treatment | no estimate extracted | 1 study · 28 participants | Low Downgraded: imprecision |
Affective instabilityDIB‐R3‐affect Schema‐Focused Therapy‐Group (SFT‐G) vs treatment | no estimate extracted | 1 study · 28 participants | Low Downgraded: imprecision |
ImpulsivityDIB‐R3‐impulses Schema‐Focused Therapy‐Group (SFT‐G) vs treatment | no estimate extracted | 1 study · 28 participants | Low Downgraded: imprecision |
interpersonal problemsDIB‐R3‐interpersonal Schema‐Focused Therapy‐Group (SFT‐G) vs treatment | no estimate extracted | 1 study · 28 participants | Low Downgraded: imprecision |
Dissociation/psychoticismDIB‐R3‐cognition Schema‐Focused Therapy‐Group (SFT‐G) vs treatment | no estimate extracted | 1 study · 28 participants | Low Downgraded: imprecision |
Systems training for emotional predictability and problem solving for borderline personality disorder (STEPPS) versus treatment as usual (TAU) for borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityBEST1 Systems training for emotional predictability and problem solving for borderline personality disorder (STEPPS) vs treatment | no estimate extracted | 1 study · 124 participants | Moderate Downgraded: imprecision |
Affective instabilityZAN‐BPD3‐affective subscale Systems training for emotional predictability and problem solving for borderline personality disorder (STEPPS) vs treatment | no estimate extracted | 1 study · 124 participants | Moderate Downgraded: imprecision |
ImpulsivityBIS4 Systems training for emotional predictability and problem solving for borderline personality disorder (STEPPS) vs treatment | no estimate extracted | 1 study · 124 participants | Moderate Downgraded: imprecision |
Interpersonal problemsZAN‐BPD3‐disturbed relations Systems training for emotional predictability and problem solving for borderline personality disorder (STEPPS) vs treatment | no estimate extracted | 1 study · 124 participants | Moderate Downgraded: imprecision |
Dissociation/psychoticismZAN‐BPD3‐cognitive subscale Systems training for emotional predictability and problem solving for borderline personality disorder (STEPPS) vs treatment | no estimate extracted | 1 study · 124 participants | Moderate Downgraded: imprecision |
Systems training for emotional predictability and problem solving for borderline personality disorder + individual therapy (STEPPS+IT) versus treatment as usual (TAU) for borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD total severityBPD‐401 Systems training for emotional predictability and problem solving for borderline personality disorder + individual therapy (STEPPS+IT) vs treatment | no estimate extracted | 1 study · 52 participants | Low Downgraded: imprecision |
Impulsivityno. of participants scoring above BPDSI‐IV3 impulsivity cut‐off score Systems training for emotional predictability and problem solving for borderline personality disorder + individual therapy (STEPPS+IT) vs treatment | RR 0.93 [0.66, 1.29] | 1 study · 58 participants | Low Downgraded: imprecision |
Parasuicidalityno. of participants scoring above BPDSI‐IV3 parasuicide cut‐off score Systems training for emotional predictability and problem solving for borderline personality disorder + individual therapy (STEPPS+IT) vs treatment | RR 1.32 [0.78, 2.22] | 1 study · 58 participants | Low Downgraded: imprecision |
Interpersonal problemsWHOQOL‐BREF4‐social relationships (mean scores multiplied by ‐1) Systems training for emotional predictability and problem solving for borderline personality disorder + individual therapy (STEPPS+IT) vs treatment | no estimate extracted | 1 study · 53 participants | Low Downgraded: imprecision |
Manual‐assisted cognitive treatment (MACT) versus treatment as usual (TAU) for borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
SuicidalitySBQ1 Manual‐assisted cognitive treatment (MACT) vs treatment | no estimate extracted | 1 study · 28 participants | Low Downgraded: imprecision |
ParasuicidalityPHI3‐deliberate self‐harm frequency Manual‐assisted cognitive treatment (MACT) vs treatment | no estimate extracted | 1 study · 28 participants | Low Downgraded: imprecision |
Psychoeducation (PE) versus waiting list (WL) for borderline personality disorder
Population: patients with borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
ImpulsivityZAN‐BPD1‐impulsivity baseline to endpoint change Psychoeducation (PE) vs waiting list (WL) | no estimate extracted | 1 study · 50 participants | Low Downgraded: imprecision |
Interpersonal problemsZAN‐BPD1‐stormy relationships baseline to endpoint change Psychoeducation (PE) vs waiting list (WL) | no estimate extracted | 1 study · 50 participants | Low Downgraded: imprecision |