Abstract
BackgroundFollow-up studies revealed that subjects with borderline personality disorder (BPD) present high rates of clinical remission, although psychosocial functioning often remains impaired. The aim of this study is to evaluate the efficacy of a cognitive rehabilitation intervention versus a psychoeducational program on psychosocial functioning in subjects with BPD.MethodsA multicenter, randomized, and positive-controlled clinical trial was conducted. Seventy outpatients with BPD were randomized to cognitive rehabilitation or psychoeducational group interventions. Participants were evaluated after completion of the intervention period (16 weeks) and after the follow-up period (6 months). Psychosocial functioning, clinical and neuropsychological outcomes were evaluated.ResultsNo main effects of group or group x time were observed on functionality but a significant effect of time was found. Post-hoc analyses showed that only cognitive rehabilitation increased psychosocial functioning significantly at endpoint. Psychoeducation showed a significant enhancement of depressive symptoms.ConclusionsCognitive rehabilitation and psychoeducational interventions appeared to show good efficacy in improving disabilities in daily life in subjects with BPD. These interventions are easily implemented in mental health settings and have the advantage of improving general functioning and clinical symptoms.Trial registrationClinicaltrials.gov:NCT02033044. Registered 9 January 2014Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-015-0640-5) contains supplementary material, which is available to authorized users.
Highlights
Follow-up studies revealed that subjects with borderline personality disorder (BPD) present high rates of clinical remission, psychosocial functioning often remains impaired
It is often accepted that psychosocial dysfunction is partly caused by cognitive deficits that remained impaired after clinical remission in other mental disorders such as schizophrenia and bipolar disorder [5, 6], but there are few studies addressing this issue in BPD
In summary, preliminary results from the present study seem to suggest that both cognitive rehabilitation and psychoeducational interventions could be efficacious in subjects with BPD to treat functional disabilities in daily life
Summary
Follow-up studies revealed that subjects with borderline personality disorder (BPD) present high rates of clinical remission, psychosocial functioning often remains impaired. Recent neuroimaging studies in BPD have reported structural and functional abnormalities in many brain areas supporting the assumption of a dysfunctional frontolimbic network in subjects with BPD [1, 11,12,13,14,15]. Such abnormalities are compatible with the cognitive impairment observed in BPD patients [7,8,9,10]. Some authors suggest that these neurocognitive dysfunctions in BPD may owe more to the impact of transient mood states or emotional distress than to underlying primary cognitive deficits per se [16, 17]
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