Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Current Psychiatry Reports
Erschienen in: Current Psychiatry Reports 4/2019

01.04.2019 | Personality Disorders (K Bertsch, Section Editor)

Mentalization-Based Treatment for Personality Disorders: Efficacy, Effectiveness, and New Developments

verfasst von: Jana Volkert, Sophie Hauschild, Svenja Taubner

Erschienen in: Current Psychiatry Reports | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose of the Review

This review aims to outline the most recent evidence on the efficacy and effectiveness of mentalization-based treatment (MBT) for personality disorders (PD) from 2015 to 2018 and to describe new treatment developments.

Recent Findings

Since 2015, 14 new—primarily effectiveness—MBT trials have been published. The main body of studies investigated adult populations (n = 11), patients with a borderline personality disorder (BPD) diagnosis (n = 8), and compared MBT with another psychotherapeutic treatment (n = 6). The majority of studies suggest that MBT has the potential to improve the clinical outcomes for adolescents and adults with a PD diagnosis, particularly BPD, and also with comorbid diagnoses and there are indications for changes in mentalizing being a specific mechanism of change promoted by MBT.

Summary

Despite promising findings, there is an urgent need for methodological sound and sufficiently powered studies to investigate both the efficacy and effectiveness of MBT, especially beyond BPD.
Literatur
1.
2.
Brazier J, Tumur I, Holmes M, Ferriter M, Parry G, Dent-Brown K, et al. Psychological therapies including dialectical behaviour therapy for borderline personality disorder: a systematic review and preliminary economic evaluation. Health Technol Assess. 2006;10(35):1–61.CrossRef
3.
Cristea IA, Gentili C, Cotet CD, Palomba D, Barbui C, Cuijpers P. Efficacy of psychotherapies for borderline personality disorder: a systematic review and meta-analysis. JAMA Psychiatry. 2017;74(4):319–28.CrossRef
4.
Juanmartí FB, Lizeretti NP. The efficacy of psychotherapy for borderline personality disorder: A review. Papeles del Psicólogo. 2017;38(2):148–56.
5.
6.
7.
Calati R, Courtet P. Is psychotherapy effective for reducing suicide attempt and non-suicidal self-injury rates? Meta-analysis and meta-regression of literature data. J Psychiatr Res. 2016/04/30 ed. 2016;79:8–20.CrossRef
8.
American Psychiatric Association. APA DSM-5 [Internet]. Diagnostic and statistical manual of mental disorders. 2013. (DSM-5®). American Psychiatric Pub.
9.
10.
Torgersen S. Epidemiology. In: Oldham J M, Skodol A E, Bender D S. (eds.) The American Psychiatric Publishing textbook of personality disorders. Arlington: American Psychiatric Publishing, Inc. 2005. p. 129–42.
11.
Frankenburg FR, Zanarini MC. The association between borderline personality disorder and chronic medical illnesses, poor health-related lifestyle choices, and costly forms of health care utilization. J Clin Psychiatry. 2004;65(12):1660–5.CrossRef
12.
Moran P, Romaniuk H, Coffey C, Chanen A, Degenhardt L, Borschmann R, et al. The influence of personality disorder on the future mental health and social adjustment of young adults: a population-based, longitudinal cohort study. Lancet Psychiatry. 2016;3(7):636–45.CrossRef
13.
Hiroeh U, Appleby L, Mortensen PB, Dunn G. Death by homicide, suicide, and other unnatural causes in people with mental illness: a population-based study. Lancet. 2001;358(9299):2110–2.CrossRef
14.
Oldham JM. Treatment in psychiatry borderline personality disorder and suicidality. Am J Psychiatry. 2006;163(1):20–6.CrossRef
15.
Gunderson J, Weinberg I, Choi-Kain L. Borderline Personality Disorder. Vol. 11. FOCUS: The Journal of Lifelong Learning in Psychiatry; 2013. 249–260 p
16.
Tyrer P, Reed GM, Crawford MJ. Classification, assessment, prevalence, and effect of personality disorder. Lancet. 2015;385:717–26.
17.
Jobst A, Hörz S, Birkhofer A, Martius P, Rentrop M. Einstellung von psychotherapeuten gegenüber der behandlung von patienten mit borderline persönlichkeitsstörung. Psychother Psychosom Medizinische Psychol. 2010;60(3–4):126–31.CrossRef
18.
Bateman A, Fonagy P. Mentalization-based treatment for personality disorders: a practical guide. New York: Oxford University Press. 2016.
19.
Fonagy P, Gergely G, Jurist E, Target M. Affect regulation, Mentalization, and the development of self. New York: Other Press; 2002.
20.
Katznelson H. Reflective functioning: A review. Clin Psychol Rev. 2014;34:107–17.
21.
22.
Rossouw TI, Fonagy P. mentalization-based treatment for self-harm in adolescents: A randomized controlled trial. J Am Acad Child Adolesc Psychiatry [Internet]. (2012);51(12):1304–13. Available from: trudie.rossouw@nelft.nhs.uk.
23.
Bateman A, Fonagy P. Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. Am J Psychiatry. 1999;156(10):1563–9.
24.
Bateman A, Fonagy P. Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. Am J Psychiatry. 2009;166(12):1355–64.
25.
Bales D, van Beek N, Smits M, Willemsen S, Busschbach JJV, Verheul R, et al. Treatment outcome of 18-month, day hospital mentalization-based treatment (MBT) in patients with severe borderline personality disorder in the Netherlands. J Pers Disord. 2012;26(4):568–82.
26.
Jorgensen CR, Freund C, Boye R, Jordet H, Andersen D, Kjolbye M. Outcome of mentalization-based and supportive psychotherapy in patients with borderline personality disorder: a randomized trial. Acta Psychiatr Scand. 2013 Apr;127(4):305–17.CrossRef
27.
Bateman A, Fonagy P. 8-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment versus treatment as usual. Am J Psychiatry. 2008;165(5):631–8.CrossRef
28.
Bateman A, Fonagy P. Personality Disorders : Theory , Research , and Treatment A Randomized Controlled Trial of a Mentalization-Based Borderline Personality Disorder A Randomized Controlled Trial of a Mentalization-Based Intervention (MBT-FACTS) for Families of People With. 2019;10(1):70.
29.
•• Bateman A, O’Connell J, Lorenzini N, Gardner T, Fonagy P. A randomised controlled trial of mentalization-based treatment versus structured clinical management for patients with comorbid borderline personality disorder and antisocial personality disorder. BMC Psychiatry. (2016);16:304. This RCT found a reduction of suicide attempts, self-harming behaviour, and depressive symptoms with medium to moderate effect sizes in the MBT group compared to structured clinical management for patients with both Antisocial and Borderline PD.
30.
• Falconer CJ, Cutting P, Davies EB, Hollis C, Stallard P, Moran P. Adjunctive avatar therapy for mentalization-based treatment of borderline personality disorder: A mixed-methods feasibility study. Evid Based Ment Health. 2017;20(4):123–7 This feasibility study reports promising results on the usefulness of avatar-MBT as an add-on to standard MBT with regard to facilitating perspective taking, emotional distancing and group participation in a sample of patients with BPD. CrossRef
31.
• Laurenssen EMP, Luyten P, Kikkert MJ, Westra D, Peen J, Soons MBJ, et al. Day hospital mentalization-based treatment v. specialist treatment as usual in patients with borderline personality disorder: randomized controlled trial. Psychol Med. 2018;27:1–8 This study reports significantly fewer drop-outs in the intensive day hospital MBT compared to TAU, but no significant differences between the groups in any of the outcome variables in patients with a BPD diagnosis.
32.
Möller C, Kalgren L, Sandell A, Falkenström F, Philips B. Mentalization-based therapy adherence and competence stimulates in-session mentalization in psychotherapy for borderline personality disorder with co-morbid substance dependence. Trials. 2016/07/14 ed. 2017;27(6):749–65.
33.
Philips B, Wennberg P, Konradsson P, Franck J. Mentalization-Based Treatment for Concurrent Borderline Personality Disorder and Substance Use Disorder: A Randomized Controlled Feasibility Study. Eur Addict Res. 2018/02/07 ed. 2018;24(1):1–8.CrossRef
34.
Robinson P, Hellier J, Barrett B, Barzdaitiene D, Bateman A, Bogaardt A, et al. The NOURISHED randomised controlled trial comparing mentalisation-based treatment for eating disorders (MBT-ED) with specialist supportive clinical management (SSCM-ED) for patients with eating disorders and symptoms of borderline personality disorder. Trials. 2016/11/20 ed. 2016;17(1):549.CrossRef
35.
Bales DL, Timman R, Andrea H, Busschbach JJV, Verheul R, Kamphuis JH. Effectiveness of day hospital Mentalization-based treatment for patients with severe borderline personality disorder: a matched control study. Clin Psychol Psychother. 2015;22(5):409–17.
36.
Bales DL, Timman R, Luyten P, Busschbach J, Verheul R, Hutsebaut J. Implementation of evidence-based treatments for borderline personality disorder: the impact of organizational changes on treatment outcome of mentalization-based treatment. Personal Ment Health. 2017;11(4):266–77.CrossRef
37.
Bo S, Sharp C, Beck E, Pedersen J, Gondan M, Simonsen E. First empirical evaluation of outcomes for Mentalization-based group therapy for adolescents with BPD. Personal Disord Theory Res Treat. 2017;8(4):396–401.CrossRef
38.
•• Edel MA, Raaff V, Dimaggio G, Buchheim A, Brüne M. Exploring the effectiveness of combined mentalization-based group therapy and dialectical behaviour therapy for inpatients with borderline personality disorder – A pilot study. Br J Clin Psychol. 2017;56(1):1–15 This study found that DBT+MBT was superior to DBT in reducing fearful attachment, improving affective mentalizing and reducing self-harm in a female sample of patients with BPD. CrossRef
39.
Griffiths H, Noble A, Duffy F, Schwannauer M. Innovations in practice: evaluating clinical outcome and service utilization in an AMBIT-trained tier 4 child and adolescent mental health service. Child Adolesc Ment Health. 2017;22(3):170–4.CrossRef
40.
Hauber K, Boon AE, Vermeiren R. Examining changes in personality disorder and symptomology in an adolescent sample receiving intensive mentalization based treatment: a pilot study. Child Adolesc Psychiatry Ment Health. 2017;1–7. Available from: https://​doi.​org/​10.​1186/​s13034-017-0197-9.
41.
Kvarstein EH, Pedersen G, Folmo E, Urnes Ø, Johansen MS, Hummelen B, et al. Mentalization-based treatment or psychodynamic treatment programmes for patients with borderline personality disorder - the impact of clinical severity. Psychol Psychother Theory Res Pract. 2018. 1-21.
42.
Kvarstein EH, Pedersen G, Urnes Ø, Hummelen B, Wilberg T, Karterud S. Changing from a traditional psychodynamic treatment programme to mentalization-based treatment for patients with borderline personality disorder – does it make a difference? Psychol Psychother Theory, Res Pract. 2015;88(1):71–86.
43.
Thomsen MS, Ruocco AC, Uliaszek AA, Mathiesen BB, Simonsen E. Changes in neurocognitive functioning after 6 months of Mentalization-based treatment for borderline personality disorder. J Pers Disord. 2017;31(3):306–24.
44.
Byrne G, Lees G. When the bough breaks the lighthouse programme. In: Celebi M, editor. Weaving the cradle: facilitating groups to promote attunement and bonding between parents, their babies and toddlers. London: Singing Dragon; 2017. p. 144–54.
45.
Taubner S, Gablonski T-C, Hauschild S, Schroeder-Pfeifer P, Kaess M, Wladika W, et al. Mentalization-based Treatment for adolescents with conduct disorder: feasibility and pilot study. (submitted).
46.
47.
Bateman AW, Fonagy P, editors. Handbook of mentalizing in mental health practice. Handbook of mentalizing in mental health practice. Arlington, VA, US: American Psychiatric Publishing, Inc.; 2012. xxiii, 593-xxiii, 593.
48.
•• Malda-Castillo J, Browne C, Perez-Algorta G. Mentalization-based treatment and its evidence-base status: A systematic literature review. Psychol Psychother Theory Res Pract [Internet]. 2018. [cited 10 November 2018]. Available from: j.maldacastillo@lancaster.ac.uk, This systematic literature review on the evidence-base status of MBT found that MBT is a potentially effictive method across a range of mental disorders, but concludes that future studies need to increase their methodological quality.
49.
De Meulemeester C, Vansteelandt K, Luyten P, Lowyck B. Mentalizing as a Mechanism of Change in the Treatment of Patients With Borderline Personality Disorder: A Parallel Process Growth Modeling Approach. Personal Disord Theory Res Treat. 2017;9(1):22–9.
Metadaten
Titel
Mentalization-Based Treatment for Personality Disorders: Efficacy, Effectiveness, and New Developments
verfasst von
Jana Volkert
Sophie Hauschild
Svenja Taubner
Publikationsdatum
01.04.2019
Verlag
Springer US
Erschienen in
Current Psychiatry Reports / Ausgabe 4/2019
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-019-1012-5

Weitere Artikel der Ausgabe 4/2019

Current Psychiatry Reports 4/2019 Zur Ausgabe

Autism Spectrum Disorders: Treatment, Services, Outcomes, and Community Functioning in Adolescents and Adults (ES Brodkin, Section Editor)

Women and Autism Spectrum Disorder: Diagnosis and Implications for Treatment of Adolescents and Adults

Mood Disorders (E Baca-Garcia, Section Editor)

Environmental Stressors May Drive Inflammation and Alter Neurocircuitry to Promote Suicidal Behavior

Anxiety Disorders (A Pelissolo, Section Editor)

Fear and Anxiety Disorders Related to Childbirth: Epidemiological and Therapeutic Issues

Genetic Disorders (F Goes, Section Editor)

Genetics of Alcoholism

Child and Family Disaster Psychiatry (B Pfefferbaum, Section Editor)

Terrorism Media Effects in Youth Exposed to Chronic Threat and Conflict in Israel

Personality Disorders (K Bertsch, Section Editor)

Single-Photon Emission Computed Tomography and Positron Emission Tomography Studies of Antisocial Personality Disorder and Aggression: a Targeted Review

Neu im Fachgebiet Psychiatrie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

29.05.2024 Hörstörungen Nachrichten

Hört jemand im Alter schlecht, nimmt das Hirn- und Hippocampusvolumen besonders schnell ab, was auch mit einem beschleunigten kognitiven Abbau einhergeht. Und diese Prozesse scheinen sich unabhängig von der Amyloidablagerung zu ereignen.

So wirken verschiedene Alkoholika auf den Blutdruck

23.05.2024 Störungen durch Alkohol Nachrichten

Je mehr Alkohol Menschen pro Woche trinken, desto mehr steigt ihr Blutdruck, legen Daten aus Dänemark nahe. Ob es dabei auch auf die Art des Alkohols ankommt, wurde ebenfalls untersucht.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise