May 18, 2012

Comparing Therapies for Borderline

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Robert Carlson, M.D By:

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Borderline personality disorder therapies show benefits but have some shortcomings

(dailyRx News) A variety of therapies can be used to treat borderline personality disorder (BPD). New research compares two types to see how well they help people suffering from BPD.

When two types of therapy for the treatment of BPD were compared, they both showed benefits by improving symptoms of the disorder for up to two years after treatment.

However, neither treatment seemed to help with overall function. Patients were still having trouble holding down a job or going to school.

"Talk to your psychologist about therapy options."

A recent study led by Shelley McMain, PhD, at the University of Toronto, enrolled 180 people with BPD, mostly women. They received one year of either general psychiatric management, including psychotherapy and medication, or dialectical behavior therapy (DBT).

After the year of therapy, participants were followed up with for two years to assess their symptoms and function after therapy had ended.

DBT is a group and individual therapy program administered by a trained psychologist that focuses on interpersonal function, distress tolerance and regulating emotion.

Patients in both types of therapy showed improvement in symptoms over their year of therapy.  The people with BPD in this study had less suicidal behavior, improved interpersonal function and higher quality of life during the two years after treatment. 

Over half of the people in the study were considered to be in remission at the end of the two-year follow up.

Even with the benefits of the therapies, about half the people were not working or in school.

The researchers noted that this finding is common for therapies for BPD. To date, therapies have found ways to improve symptoms, but have not successfully found ways to improve rates of overall function related to work and school.

McMain and colleagues stated in their report, “These findings are noteworthy because they confirm that the effects of both treatments extend beyond initial symptom relief and are associated with long-lasting changes across a broad range of outcomes.”

The study was designed to mimic real-world treatment, so participants were able to seek additional treatments while being in the study.  It is not clear how other treatments may have influenced the findings in this study.

The study was published in May online ahead of print in the American Journal of Psychiatry. The study was funded by the Canadian Institutes for Health Research. Paul Links, MD, a study author, reported grant support from Eli Lilly. Other authors report no financial affiliations.

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Reviewed by: 
Robert Carlson, M.D
Review Date: 
May 16, 2012

Last Updated:
July 27, 2012