Cochrane · systematic review · CD012955
Psychological therapies for people with borderline personality disorder
Storebø, OJ, Stoffers-Winterling, JM, Völlm, BA, et al. · Cochrane Database of Systematic Reviews · 2020 · 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
20
current version
GRADE rated
17
No studies
3
Included studies
NR
No studies 3 · 15%Ungraded 0 · 0%Very low 3 · 15%Low 13 · 65%Moderate 1 · 5%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
Psychotherapy versus treatment‐as‐usual
Population: borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD symptom severity Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs treatment‐as‐usual | no estimate extracted | 22 studies · 1244 participants | Moderate Downgraded: risk of bias |
Self‐harm (frequency) Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs treatment‐as‐usual | no estimate extracted | 13 studies · 616 participants | Low Downgraded: risk of bias, imprecision |
Suicide‐related outcomes (suicidality) Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs treatment‐as‐usual | no estimate extracted | 13 studies · 666 participants | Low Downgraded: risk of bias, imprecision |
Psychosocial functioning Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs treatment‐as‐usual | no estimate extracted | 22 studies · 1314 participants | Low Downgraded: risk of bias, inconsistency |
Depression Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs treatment‐as‐usual | no estimate extracted | 22 studies · 1568 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Attrition Timing of outcome assessment: end of treatment Psychotherapy vs treatment‐as‐usual | RR 1 [0.83, 1.2] | 32 studies · 2225 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects Timing of outcome assessment: end of treatment Psychotherapy vs treatment‐as‐usual | RR 0.92 [0.45, 1.88] | 2 studies · 381 participants | Low Downgraded: risk of bias, imprecision |
Psychotherapy versus waiting list or no treatment
Population: borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
BPD symptom severity Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs waiting list or no treatment | no estimate extracted | 3 studies · 161 participants | Low Downgraded: risk of bias, imprecision |
Self‐harm Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs waiting list or no treatment | no estimate extracted | 2 studies · 128 participants | Low Downgraded: risk of bias, imprecision |
Suicide‐related outcomes Measured by: self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs waiting list or no treatment | no estimate extracted | 2 studies · 108 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Psychosocial functioning Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs waiting list or no treatment | no estimate extracted | 5 studies · 219 participants | Low Downgraded: risk of bias, imprecision |
Depression Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Psychotherapy vs waiting list or no treatment | no estimate extracted | 6 studies · 239 participants | Low Downgraded: risk of bias, imprecision |
Attrition Timing of outcome assessment: end of treatment Psychotherapy vs waiting list or no treatment | RR 0.55 [0.2, 1.5] | 3 studies · 144 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects (not measured Psychotherapy vs waiting list or no treatment | no estimate extracted | NR | No studies |
Dialectical behavioural therapy or mentalisation‐based therapy versus treatment‐as‐usual
Population: borderline personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
DBT Dialectical behavioural therapy or mentalisation‐based therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
BPD severity Measured by: clinicians Timing of outcome assessment: end of treatment Dialectical behavioural therapy or mentalisation‐based therapy vs treatment‐as‐usual | no estimate extracted | 3 studies · 149 participants | Low Downgraded: risk of bias, imprecision |
Self‐harm Measured by: clinicians Timing of outcome assessment: end of treatment Dialectical behavioural therapy or mentalisation‐based therapy vs treatment‐as‐usual | no estimate extracted | 7 studies · 376 participants | Low Downgraded: risk of bias, imprecision |
Psychosocial functioning Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment Dialectical behavioural therapy or mentalisation‐based therapy vs treatment‐as‐usual | no estimate extracted | 6 studies · 225 participants | Low Downgraded: risk of bias, imprecision |
MBT Dialectical behavioural therapy or mentalisation‐based therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Suicide‐related outcomes Measured by: clinicians Timing of outcome assessment: end of treatment Dialectical behavioural therapy or mentalisation‐based therapy vs treatment‐as‐usual | RR 0.1 [0.04, 0.3] | 3 studies · 218 participants | Low Downgraded: risk of bias, imprecision |