Skip to main content
Erschienen in: Current Psychiatry Reports 1/2010

01.02.2010

Effectiveness of Different Psychotherapy Approaches in the Treatment of Borderline Personality Disorder

verfasst von: Joel Paris

Erschienen in: Current Psychiatry Reports | Ausgabe 1/2010

Einloggen, um Zugang zu erhalten

Abstract

Recent clinical trials support the conclusion that patients with borderline personality disorder are best treated with structured and specifically designed forms of psychotherapy. The strongest evidence from clinical trials favors dialectical behavior therapy and mentalization-based treatment. These methods, which have several similarities, could be shortened to make them more accessible. Successful psychotherapy in individuals with borderline personality disorder should not resemble treatment as usual but should offer a predictable structure and methods to promote emotion regulation and problem solving in current life.
Literatur
1.
Zurück zum Zitat Lieb K, Zanarini MC, Schmahl C, et al.: Borderline personality disorder. Lancet 2004, 364:453–461.CrossRefPubMed Lieb K, Zanarini MC, Schmahl C, et al.: Borderline personality disorder. Lancet 2004, 364:453–461.CrossRefPubMed
2.
Zurück zum Zitat Paris J: Clinical trials in personality disorders, Psychiatr Clin North Am 2008, 31:517–526.CrossRefPubMed Paris J: Clinical trials in personality disorders, Psychiatr Clin North Am 2008, 31:517–526.CrossRefPubMed
3.
Zurück zum Zitat Binks CA, Fenton M, McCarthy L, et al.: Pharmacological interventions for people with borderline personality disorder. Cochrane Database Syst Rev 2006:CD005653. Binks CA, Fenton M, McCarthy L, et al.: Pharmacological interventions for people with borderline personality disorder. Cochrane Database Syst Rev 2006:CD005653.
4.
Zurück zum Zitat Binks CA, Fenton M, McCarthy L, et al.: Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev 2006:CD005652. Binks CA, Fenton M, McCarthy L, et al.: Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev 2006:CD005652.
5.
Zurück zum Zitat Skodol AE, Buckley P, Charles E: Is there a characteristic pattern in the treatment history of clinic outpatients with borderline personality? J Nerv Ment Dis 1983, 171:405–410.PubMedCrossRef Skodol AE, Buckley P, Charles E: Is there a characteristic pattern in the treatment history of clinic outpatients with borderline personality? J Nerv Ment Dis 1983, 171:405–410.PubMedCrossRef
6.
Zurück zum Zitat Paris J: Treatment of Borderline Personality Disorder: A Guide to Evidence-based Practice. New York: Guilford Press; 2008. Paris J: Treatment of Borderline Personality Disorder: A Guide to Evidence-based Practice. New York: Guilford Press; 2008.
7.
Zurück zum Zitat Paris J: Personality Disorders Over Time. Washington, DC: American Psychiatric Press; 2003. Paris J: Personality Disorders Over Time. Washington, DC: American Psychiatric Press; 2003.
8.
Zurück zum Zitat Skodol AE, Gunderson JG, Shea MT, et al.: The Collaborative Longitudinal Personality Disorders Study (CLPS): overview and implications. J Pers Disord 2005, 19:487–504.CrossRefPubMed Skodol AE, Gunderson JG, Shea MT, et al.: The Collaborative Longitudinal Personality Disorders Study (CLPS): overview and implications. J Pers Disord 2005, 19:487–504.CrossRefPubMed
9.
Zurück zum Zitat Zanarini MC, Frankenburg FR, Hennen J, et al.: The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up. J Pers Disord 2005, 19:505–523.CrossRefPubMed Zanarini MC, Frankenburg FR, Hennen J, et al.: The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up. J Pers Disord 2005, 19:505–523.CrossRefPubMed
10.
Zurück zum Zitat Linehan MM: Dialectical Behavioral Therapy of Borderline Personality Disorder. New York: Guilford Press; 1993. Linehan MM: Dialectical Behavioral Therapy of Borderline Personality Disorder. New York: Guilford Press; 1993.
11.
Zurück zum Zitat Linehan MM, Armstrong HE, Suarez A, et al.: Cognitive behavioral treatment of chronically parasuicidal borderline patients. Arch Gen Psychiatry 1991, 48:1060–1064.PubMed Linehan MM, Armstrong HE, Suarez A, et al.: Cognitive behavioral treatment of chronically parasuicidal borderline patients. Arch Gen Psychiatry 1991, 48:1060–1064.PubMed
12.
Zurück zum Zitat Linehan MM, Heard HL, Armstrong HE: Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Arch Gen Psychiatry 1993, 50:971–974.PubMed Linehan MM, Heard HL, Armstrong HE: Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Arch Gen Psychiatry 1993, 50:971–974.PubMed
13.
Zurück zum Zitat Koons CR, Robins CJ, Tweed JL, et al.: Efficacy of dialectical behavior therapy with borderline women veterans: a randomized controlled trial. Behav Ther 2001, 32:371–390.CrossRef Koons CR, Robins CJ, Tweed JL, et al.: Efficacy of dialectical behavior therapy with borderline women veterans: a randomized controlled trial. Behav Ther 2001, 32:371–390.CrossRef
14.
Zurück zum Zitat Verheul R, Van Den Bosch LM, Koeter MW, et al.: Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands. Br J Psychiatry 2003, 182:135–140.CrossRefPubMed Verheul R, Van Den Bosch LM, Koeter MW, et al.: Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands. Br J Psychiatry 2003, 182:135–140.CrossRefPubMed
15.
Zurück zum Zitat Bohus M, Haaf B, Simms T, et al.: Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial. Behav Res Ther 2004, 42:487–499.CrossRefPubMed Bohus M, Haaf B, Simms T, et al.: Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial. Behav Res Ther 2004, 42:487–499.CrossRefPubMed
16.
Zurück zum Zitat Linehan MM, Comtois KA, Murray AM, et al.: Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry 2006, 63:757–766. (Published erratum appears in Arch Gen Psychiatry 2007, 64:1401.) Linehan MM, Comtois KA, Murray AM, et al.: Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry 2006, 63:757–766. (Published erratum appears in Arch Gen Psychiatry 2007, 64:1401.)
17.
Zurück zum Zitat Stanley B, Brodsky B, Nelson JD, Dulit R: Brief dialectical behavior therapy for suicidality and self-injurious behaviors. Arch Suicide Res 2007, 11:337–341.CrossRefPubMed Stanley B, Brodsky B, Nelson JD, Dulit R: Brief dialectical behavior therapy for suicidality and self-injurious behaviors. Arch Suicide Res 2007, 11:337–341.CrossRefPubMed
18.
Zurück zum Zitat • McMain SF, Links PS, Gnam WH, et al.: A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. Am J Psychiatry 2009 Sep 15 (Epub ahead of print). This study shows that DBT can be matched by another highly structured psychotherapy. • McMain SF, Links PS, Gnam WH, et al.: A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. Am J Psychiatry 2009 Sep 15 (Epub ahead of print). This study shows that DBT can be matched by another highly structured psychotherapy.
19.
Zurück zum Zitat Oldham JM, Gabbard GO, Goin MK, et al.: American Psychiatric Association Practice Guidelines: Practice Guideline for the treatment of borderline personality disorder. Am J Psychiatry 2001, 158(10 Suppl):1–52. Oldham JM, Gabbard GO, Goin MK, et al.: American Psychiatric Association Practice Guidelines: Practice Guideline for the treatment of borderline personality disorder. Am J Psychiatry 2001, 158(10 Suppl):1–52.
20.
Zurück zum Zitat Bateman A, Fonagy P: Psychotherapy for Borderline Personality Disorder: Mentalization Based Treatment. Oxford: Oxford University Press; 2004. Bateman A, Fonagy P: Psychotherapy for Borderline Personality Disorder: Mentalization Based Treatment. Oxford: Oxford University Press; 2004.
21.
Zurück zum Zitat Bateman A, Fonagy P: Mentalization Based Treatment: A Practical Guide. New York: John Wiley; 2006. Bateman A, Fonagy P: Mentalization Based Treatment: A Practical Guide. New York: John Wiley; 2006.
22.
Zurück zum Zitat Bateman A, Fonagy P: Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. Am J Psychiatry 1999, 156:1563–1569.PubMed Bateman A, Fonagy P: Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. Am J Psychiatry 1999, 156:1563–1569.PubMed
23.
Zurück zum Zitat 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, 165:631–638.CrossRefPubMed 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, 165:631–638.CrossRefPubMed
24.
Zurück zum Zitat • Bateman A, Fonagy P: Randomized controlled trial of out-patient mentalization based treatment versus structured clinical management for borderline personality disorder. Am J Psychiatry 2009 Oct 15 (Epub ahead of print). This study shows that MBT is effective as an outpatient therapy. • Bateman A, Fonagy P: Randomized controlled trial of out-patient mentalization based treatment versus structured clinical management for borderline personality disorder. Am J Psychiatry 2009 Oct 15 (Epub ahead of print). This study shows that MBT is effective as an outpatient therapy.
25.
Zurück zum Zitat Choi-Kain LW, Gunderson JG: Mentalization: ontogeny, assessment, and application in the treatment of borderline personality disorder. Am J Psychiatry 2008, 165:1127–1135.CrossRefPubMed Choi-Kain LW, Gunderson JG: Mentalization: ontogeny, assessment, and application in the treatment of borderline personality disorder. Am J Psychiatry 2008, 165:1127–1135.CrossRefPubMed
26.
Zurück zum Zitat Brown GK, Newman CF, Charlesworth SE, et al.: An open clinical trial of cognitive therapy for borderline personality disorder. J Pers Disord 2004, 18:257–271.CrossRefPubMed Brown GK, Newman CF, Charlesworth SE, et al.: An open clinical trial of cognitive therapy for borderline personality disorder. J Pers Disord 2004, 18:257–271.CrossRefPubMed
27.
Zurück zum Zitat Tyrer P, Thompson S, Schmidt U, et al.: Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: the POPMACT study. Psychol Med 2003, 33:969–976.CrossRefPubMed Tyrer P, Thompson S, Schmidt U, et al.: Randomized controlled trial of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: the POPMACT study. Psychol Med 2003, 33:969–976.CrossRefPubMed
28.
Zurück zum Zitat Davidson K, Norrie J, Tyrer P, et al.: The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the Borderline Personality Disorder Study of Cognitive Therapy (BOSCOT) trial. J Pers Disord 2006, 20:450–465.CrossRefPubMed Davidson K, Norrie J, Tyrer P, et al.: The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the Borderline Personality Disorder Study of Cognitive Therapy (BOSCOT) trial. J Pers Disord 2006, 20:450–465.CrossRefPubMed
29.
Zurück zum Zitat Davidson K, Tyrer P, Gumley A, et al.: A randomized controlled trial of cognitive behavior therapy for borderline personality disorder: rationale for trial, method, and description of sample. J Pers Disord 2006, 20:431–449.CrossRefPubMed Davidson K, Tyrer P, Gumley A, et al.: A randomized controlled trial of cognitive behavior therapy for borderline personality disorder: rationale for trial, method, and description of sample. J Pers Disord 2006, 20:431–449.CrossRefPubMed
30.
Zurück zum Zitat Palmer S, Davidson K, Tyrer P, et al.: The cost-effectiveness of cognitive behavior therapy for borderline personality disorder: results from the BOSCOT trial. J Pers Disord 2006, 20:466–481.CrossRefPubMed Palmer S, Davidson K, Tyrer P, et al.: The cost-effectiveness of cognitive behavior therapy for borderline personality disorder: results from the BOSCOT trial. J Pers Disord 2006, 20:466–481.CrossRefPubMed
31.
Zurück zum Zitat Weinberg I, Gunderson JG, Hennen J, Cutter CJ Jr: Manual assisted cognitive treatment for deliberate self-harm in borderline personality disorder patients. J Pers Disord 2006, 20:482–492.CrossRefPubMed Weinberg I, Gunderson JG, Hennen J, Cutter CJ Jr: Manual assisted cognitive treatment for deliberate self-harm in borderline personality disorder patients. J Pers Disord 2006, 20:482–492.CrossRefPubMed
32.
Zurück zum Zitat Huband N, McMurran M, Evans C, Duggan C: Social problem-solving plus psychoeducation for adults with personality disorder: pragmatic randomised controlled trial. Br J Psychiatry 2007, 190:307–331.CrossRefPubMed Huband N, McMurran M, Evans C, Duggan C: Social problem-solving plus psychoeducation for adults with personality disorder: pragmatic randomised controlled trial. Br J Psychiatry 2007, 190:307–331.CrossRefPubMed
33.
Zurück zum Zitat Blum N, St. John D, Pfohl B, et al.: Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up. Am J Psychiatry 2008, 165:468–478. (Published erratum appears in Am J Psychiatry 2008, 165:777.) Blum N, St. John D, Pfohl B, et al.: Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up. Am J Psychiatry 2008, 165:468–478. (Published erratum appears in Am J Psychiatry 2008, 165:777.)
34.
Zurück zum Zitat Clarkin JF, Levy KN, Lenzenweger MF, Kernberg OF: Evaluating three treatments for borderline personality disorder: a multiwave study. Am J Psychiatry 2007, 164:922–928.CrossRefPubMed Clarkin JF, Levy KN, Lenzenweger MF, Kernberg OF: Evaluating three treatments for borderline personality disorder: a multiwave study. Am J Psychiatry 2007, 164:922–928.CrossRefPubMed
35.
Zurück zum Zitat Young, JE: Cognitive Therapy for Personality Disorders: A Schema Focused Approach, edn 3. Sarasota, FL: Professional Resource Press; 1999. Young, JE: Cognitive Therapy for Personality Disorders: A Schema Focused Approach, edn 3. Sarasota, FL: Professional Resource Press; 1999.
36.
Zurück zum Zitat Giesen-Bloo J, van Dyck R, Spinhoven P, et al.: Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy Arch Gen Psychiatry 2006, 63:649–658. (Published erratum appears in Arch Gen Psychiatry 2006, 63:1008.) Giesen-Bloo J, van Dyck R, Spinhoven P, et al.: Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy Arch Gen Psychiatry 2006, 63:649–658. (Published erratum appears in Arch Gen Psychiatry 2006, 63:1008.)
37.
Zurück zum Zitat Ryle A, Leighton T, Pollock P: Cognitive Analytic Therapy and Borderline Personality Disorder: The Model and the Method. Hoboken, NJ: John Wiley; 1997. Ryle A, Leighton T, Pollock P: Cognitive Analytic Therapy and Borderline Personality Disorder: The Model and the Method. Hoboken, NJ: John Wiley; 1997.
38.
Zurück zum Zitat Chanen AM, Jackson, HJ, McCutcheon LK, et al.: Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: randomised controlled trial. Br J Psychiatry 2008, 193:477–484. (Published erratum appears in Br J Psychiatry 2009, 194:191.) Chanen AM, Jackson, HJ, McCutcheon LK, et al.: Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: randomised controlled trial. Br J Psychiatry 2008, 193:477–484. (Published erratum appears in Br J Psychiatry 2009, 194:191.)
39.
Zurück zum Zitat Wampold BE: The Great Psychotherapy Debate: Models, Methods, and Findings. Mahwah, NJ: Lawrence Erlbaum Associates; 2001. Wampold BE: The Great Psychotherapy Debate: Models, Methods, and Findings. Mahwah, NJ: Lawrence Erlbaum Associates; 2001.
40.
Zurück zum Zitat Gunderson JG, Links P: Borderline Personality Disorder: A Clinical Guide, edn 2. Washington, DC: American Psychiatric Press; 2008. Gunderson JG, Links P: Borderline Personality Disorder: A Clinical Guide, edn 2. Washington, DC: American Psychiatric Press; 2008.
41.
Zurück zum Zitat Stern A: Psychoanalytic investigation of and therapy in the borderline group of neuroses. Psychoanal Q 1938, 7:467–489. Stern A: Psychoanalytic investigation of and therapy in the borderline group of neuroses. Psychoanal Q 1938, 7:467–489.
42.
Zurück zum Zitat Koenigsberg H: Neural correlates of borderline personality disorder symptoms. Paper presented at the International Society for the Study of Personality Disorders. New York, NY; August 2009. Koenigsberg H: Neural correlates of borderline personality disorder symptoms. Paper presented at the International Society for the Study of Personality Disorders. New York, NY; August 2009.
43.
Zurück zum Zitat Frank JD, Frank JB: Persuasion and Healing, edn 3. Baltimore, MD: Johns Hopkins; 1991. Frank JD, Frank JB: Persuasion and Healing, edn 3. Baltimore, MD: Johns Hopkins; 1991.
Metadaten
Titel
Effectiveness of Different Psychotherapy Approaches in the Treatment of Borderline Personality Disorder
verfasst von
Joel Paris
Publikationsdatum
01.02.2010
Verlag
Current Science Inc.
Erschienen in
Current Psychiatry Reports / Ausgabe 1/2010
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-009-0083-0

Weitere Artikel der Ausgabe 1/2010

Current Psychiatry Reports 1/2010 Zur Ausgabe

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

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