Efficacy of Dialectical Behavioral Therapy for Emotion Dysregulation in Patients with Dual Diagnosis of Borderline Personality Disorder and Substance Use Disorder

Abstract

Background: The published evidence supports the efficacy of dialectical behavioral therapy (DBT) to treat patients with borderline personality disorder and particular emphasis on emotion dysregulation as a psychopathological construct. Aim: To assess the efficacy of DBT for improving emotion dysregulation among patients with dual diagnosis of borderline personality disorder and substance use disorder. Methods: We recruited 40 patients meeting DSM-5 criteria for borderline personality disorder and substance use disorder and assigned them to one of two groups of 20 participants each. One group underwent DBT therapy and the other group followed a treatment-as-usual (TAU) protocol over one year. We used the scores of the difficulties in emotion regulation scale (DERS) at baseline, immediately after therapy, and 4 months after therapy to assess emotion dysregulation. Results: We found significant improvements (p<0.05) in the DBT group after therapy that were maintained at least for 4 months afterwards based on the DERS scores (including subscale scores). More patients dropped out of the treatment in the TAU group than in the DBT group. Conclusion: DBT is a potentially efficacious psychological intervention to treat emotion dysregulation in patients with borderline personality disorder and substance use disorder.