Clinical Question

Is psychotherapy beneficial for patients with borderline personality disorder (BPD)?

Evidence-Based Answer

In patients with BPD, psychotherapy in the form of dialectical behavior therapy (DBT) or mentalization-based treatment (MBT) reduces the severity of symptoms, improves psychosocial functioning, and reduces depression scores compared with no treatment. (Strength of Recommendation [SOR]: B, inconsistent or limited-quality patient-oriented evidence.) In addition, DBT and MBT reduce the severity of BPD symptoms compared with usual treatment, including other types of psychotherapies.¹ (SOR: B, inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

BPD is defined by a pervasive pattern of instability in affect regulation, impulse control, interpersonal relationships, and self-image. ² The prevalence in the primary care setting is approximately 6%, but the disorder is frequently underdiagnosed and undertreated. ^3,4 BPD is often characterized by comorbid psychiatric disorders and difficulties in patient-physician relationships, highlighting the importance of effective therapies.^3,4