Abstract
Borderline Personality Disorder (BPD) significantly impairs functioning. Fortunately, effective treatments are available for borderline symptoms but their effect on functioning should be assessed. The objective of this meta-analysis is to assess the effect of specifically-designed versus non-specifically designed psychotherapies on function in adult patients with BPD. The reference list of Cristea et al. 2017 was used to identify the randomized controlled trials (RCTs) assessing the BPD-specifically-designed psychotherapy versus non-specific psychotherapies in adult BPD patients. Among those, RCTs assessing post-treatment functioning using the Global Assessment of Functioning, Social Adjustment Scale–Self-Report and Inventory of Interpersonal Problems were included. Ten trials (880 participants) were included. Summary effect size was calculated using the measured Hedge’s g. The results indicate the BPD patients in the intervention group had a significantly higher (g = 0.41; 95% CI, 0.09–0.73) level of psychosocial functioning after receiving the specifically-designed psychotherapies in comparison with BPD patients in control groups after receiving non-specific psychotherapies. Specifically-designed psychotherapies can improve psychosocial functioning although improvement in measurement of function (i.e., more objective and universal tools) and improvement in psychotherapies (i.e., more focused on general functioning) will be helpful.
Highlights
Borderline Personality Disorder (BPD) significantly impairs psychosocial functioning and this is regardless of individuals’ gender [1] or settings [2].By nature, BPD disturbs both self and interpersonal domains causing severe reduction in the level of psychosocial functioning [3]
The results indicate the BPD patients in the intervention group had a significantly higher (g = 0.41; 95% confidence interval (CI), 0.09–0.73) level of psychosocial functioning after receiving the -designed psychotherapies in comparison with BPD patients in control groups after receiving non-specific psychotherapies
Ten trials with 880 intention-to-treat participants were included. 23 studies were excluded for the following reasons: 17 did not measure post-treatment psychosocial functioning, 3 studies used SCL-90-R which assesses more symptoms rather than psychosocial functioning, 1 used the Functioning Assessment Short Test (FAST) and this study was excluded because it was the only randomized controlled trials (RCTs) using this tool, and 2 did not have enough information in the published article
Summary
Borderline Personality Disorder (BPD) significantly impairs psychosocial functioning and this is regardless of individuals’ gender [1] or settings (general population or clinical/hospital settings) [2]. BPD disturbs both self and interpersonal domains causing severe reduction in the level of psychosocial functioning [3]. This degree of impairment is significantly greater than that of depression when assessed in the clinical population [4]. When considering the clinical course of BPD over a ten-year period, psychosocial functioning is severely impaired with long-lasting effects while symptoms of BPD more readily remit and infrequently relapse [5]. The proportion of BPD patients increases to 10–22% when it comes to individuals seeking help in mental health clinics and hospitals [7]
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