Dialectical behaviour therapy v. mentalisation-based therapy for borderline personality disorder
File(s)
Author(s)
Barnicot, Kirsten
Crawford, Mike
Type
Journal Article
Abstract
BACKGROUND: Dialectical behaviour therapy (DBT) and mentalisation-based therapy (MBT) are both widely used evidence-based treatments for borderline personality disorder (BPD), yet a head-to-head comparison of outcomes has never been conducted. The present study therefore aimed to compare the clinical outcomes of DBT v. MBT in patients with BPD. METHODS: A non-randomised comparison of clinical outcomes in N = 90 patients with BPD receiving either DBT or MBT over a 12-month period. RESULTS: After adjusting for potentially confounding differences between participants, participants receiving DBT reported a significantly steeper decline over time in incidents of self-harm (adjusted IRR = 0.93, 95% CI 0.87-0.99, p = 0.02) and in emotional dysregulation (adjusted β = -1.94, 95% CI -3.37 to -0.51, p < 0.01) than participants receiving MBT. Differences in treatment dropout and use of crisis services were no longer significant after adjusting for confounding, and there were no significant differences in BPD symptoms or interpersonal problems. CONCLUSIONS: Within this sample of people using specialist personality disorder treatment services, reductions in self-harm and improvements in emotional regulation at 12 months were greater amongst those receiving DBT than amongst those receiving MBT. Experimental studies assessing outcomes beyond 12 months are needed to examine whether these findings represent differences in the clinical effectiveness of these therapies.
Date Issued
2019-09-01
Date Acceptance
2018-05-31
Citation
Psychological Medicine, 2019, 49 (12), pp.2060-2068
ISSN
0033-2917
Publisher
Cambridge University Press (CUP)
Start Page
2060
End Page
2068
Journal / Book Title
Psychological Medicine
Volume
49
Issue
12
Copyright Statement
© 2018 Cambridge University Press. This paper has been accepted for publication and will appear in a revised form, subsequent to peer-review and/or editorial input by Cambridge University Press.
Sponsor
National Institute for Health Research
National Institute for Health Research
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30303061
PII: S0033291718002878
Grant Number
PDF-2013-06-054
NIHR PDF-2013-06-054
Subjects
Behaviour therapy
borderline personality disorder
psychodynamic therapy
psychological treatment
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2018-10-10