Multimodal approaches to the treatment of personality disorder
File(s)
Author(s)
Tyrer, Peter
King, Jacob
Mulder, Roger
Type
Journal Article
Abstract
Introduction
Personality disorder is the most common of all psychiatric disorders and is best perceived as a diagnostic spectrum extending from no personality dysfunction to severe personality disorder. The position on the spectrum is determined mainly by problems in interpersonal social dysfunction, self-perception and awareness, and dangers to the self and others.
Areas covered
We examine psychological and psychodynamic treatments, pharmacotherapy, neuromodulation and other related approaches, environmental treatments, and therapeutic communities. Although many published studies refer to individual categories, these are now linked to the diagnostic spectrum in this review.
Expert opinion
There is some evidence that focused psychological treatments linked to problem solving (STEPPS), mentalization based therapy and dialectical behavior therapy, are successful in treating moderately severe personality disorder, especially regarding self-harm, but there is also benefit from well organized standard care that is similarly effective. There is no good evidence that drug treatment is of real value in personality disorder. Brain stimulation approaches have limited evidence. Psychodynamic approaches, environmental interventions, nidotherapy, and therapeutic communities appear to be of some value, but good data are few. Long-term studies of treatment effectiveness are few but some show that personality disorder can respond to treatment and remit.
Personality disorder is the most common of all psychiatric disorders and is best perceived as a diagnostic spectrum extending from no personality dysfunction to severe personality disorder. The position on the spectrum is determined mainly by problems in interpersonal social dysfunction, self-perception and awareness, and dangers to the self and others.
Areas covered
We examine psychological and psychodynamic treatments, pharmacotherapy, neuromodulation and other related approaches, environmental treatments, and therapeutic communities. Although many published studies refer to individual categories, these are now linked to the diagnostic spectrum in this review.
Expert opinion
There is some evidence that focused psychological treatments linked to problem solving (STEPPS), mentalization based therapy and dialectical behavior therapy, are successful in treating moderately severe personality disorder, especially regarding self-harm, but there is also benefit from well organized standard care that is similarly effective. There is no good evidence that drug treatment is of real value in personality disorder. Brain stimulation approaches have limited evidence. Psychodynamic approaches, environmental interventions, nidotherapy, and therapeutic communities appear to be of some value, but good data are few. Long-term studies of treatment effectiveness are few but some show that personality disorder can respond to treatment and remit.
Date Issued
2025-07-01
Date Acceptance
2025-05-30
Citation
Expert Review of Neurotherapeutics, 2025, 25 (7), pp.869-879
ISSN
1473-7175
Publisher
Taylor and Francis Group
Start Page
869
End Page
879
Journal / Book Title
Expert Review of Neurotherapeutics
Volume
25
Issue
7
Copyright Statement
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/40448559
Subjects
adaptive therapies
BORDERLINE
CARE
Clinical Neurology
COGNITIVE ANALYTIC THERAPY
DIALECTICAL BEHAVIOR-THERAPY
EMOTIONAL PREDICTABILITY
FOLLOW-UP
Life Sciences & Biomedicine
MANAGEMENT
Neurosciences & Neurology
NIDOTHERAPY
Personality disorder
Pharmacology & Pharmacy
pharmacotherapy
PROBLEM-SOLVING STEPPS
pscyhological treatments
RANDOMIZED CONTROLLED-TRIAL
review
Science & Technology
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2025-06-19