Evidence Tables for Additional Studies Reviewed
Repetitive Transcranial Magnetic Stimulation Versus Sham
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Cailhol et al. (2014) | Design: Double-blinded RCT Setting: Outpatient, single center Country: France Funding: University Hospital of Toulouse | N = 9 G1 (4): Sham rTMS G2 (5): rTMS frequency: 10 Hz, 80% of motor threshold, total 2,000 pulses per session; 10 sessions Duration: 2 weeks | Inclusion: Ages 20–45 years; DSM-IV and DIB-R criteria for BPD Exclusion: Bipolar I disorder, alcohol dependency, current MDE or PTSD; contraindication to rTMS | Mean age, years (SD): NR Female: 89% Race/ethnicity: NR | Primary outcome: BPDSI at 3 months No significant differences in BPDSI, MADRS, SCL-90, GAS Incidence of AEs: NR Withdrawal due to AEs: NR Attrition: 0% Differential attrition: 0% | Moderate |
Abandonment Psychotherapy Versus Treatment as Usual
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Andreoli et al. (2016) | Design: RCT Setting: Outpatient, single center Country: Switzerland Funding: NR | N = 170 G1 (30): TAU: intensive community treatment G2 (70): Manualized AP: Two sessions per week delivered by nurses with experience in management of patients with BPD, plus antidepressant medications Duration: 3 months | Inclusion: Ages 18–60 years; DSM-IV BPD and MDD diagnoses Exclusion: DSM-IV psychotic disorder, bipolar I disorder, SUD, or intellectual disability; inability to speak French | Mean age, years (SD): 32 (10.1) Female: 84% Race/ethnicity: NR | Primary outcome: Suicidal relapse, rehospitalization, clinical remission (GAS > 60) at 3 months G2 significantly more effective than G1 to reduce suicidal relapse (12.9% vs. 40.0%, P <0.005) and rehospitalization (14.3% vs. 36%, P <0.01), to achieve 50% reduction in Ham-D (65.7% vs. 33.3%, P <0.005), and improve GAS (62.7 vs. 36.7, P <0.01) Incidence of AEs: G1: 100% (30/30) G2: 100% (70/70) Withdrawal due to AEs: NR Attrition: 12% Differential attrition: G1: 37% (11/30) G2: 6% (4/70) | Moderate |
Schema-Focused Therapy Versus Treatment as Usual
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Farrell et al. (2009) | Design: RCT Setting: Outpatient, multicenter Country: United States Funding: Government, NIMH | N = 32 G1 (16): TAU: Weekly individual psychotherapy in community G2 (16): SFT plus TAU: 30 weekly group sessions, each lasting 90 minutes; combination of emotional awareness training, BPD psychoeducation, distress management training, and schema-focused change work; sessions consisted of discussing homework from previous session, presenting new information, a question-and-answer session, experiential or cognitive work, and homework assignment Duration: 8 months Follow-up: 6 months | Inclusion: Females; age 18–65 years; met criteria for BPD from DIPD-R and BSI; in individual psychotherapy of ≥ 6 months duration and stable Exclusion: Axis I diagnosis of psychotic disorder or presence of psychosis; below-average IQ (89) on Shipley Institute of Living Scale | Mean age, years (SD): G1: 36 (8.08) G2: 35 (9.30) Female: 100% Race/ethnicity: NR | Primary outcome: NR G2 significantly more effective than G1 at 14-month follow-up (6 months after end of treatment) for BPD diagnosis (measured by DIB-R; 0% vs. 83%, P < 0.001), BPD symptoms (measured by BSI; 15.75 vs. 33.08, P < 0.001), global severity of psychiatric symptoms (measured by SCL-90; 0.96 vs. 1.93, P < 0.001), and improved global functioning (measured by GAF; 66.19 vs. 48.25, P < 0.001) Attrition: 12.5% (4/32) G1: 25% (4/16) G2: 0% (0/16) | Moderate |
Leppänen et al. (2016) | Design: RCT Setting: Outpatient, multicenter Country: Finland Funding: NR | N = 71 G1 (47): TAU; treatment in accordance with current practices of Oulu city mental health care services; treatments vary widely, from supportive weekly psychotherapy sessions to visits every few weeks and from occasional appointments for medication control to home rehabilitation G2 (24): SFT-based psychoeducational group integrated into individual therapy: 45- to 60-minute individual therapy sessions once a week, a total of forty 90-minute psychoeducational group sessions (approximately once a week), and materials for patients to practice therapy exercises at home Duration: 12 months | Inclusion: Age ≥ 20 years; fulfilled SCID-II criteria for BPD; severe symptoms of BPD, including parasuicidal behavior (e.g., cutting, other forms of self-harm, impulsive overdosing of medicines); attempted suicide; considerable emotional instability affecting social and professional life; previous unsuccessful treatments (one or more) Exclusion: Schizophrenia spectrum diseases/psychoses, bipolar disorder (type I), neuropsychiatric disorder, severe substance abuse problem, Axis I disorders diagnosed according to SCID-I, or presence of neuropsychiatric disorder | Mean age, years (SD): G1: 32 (8.8) G2: 32 (8.3) Female: 86% Race/ethnicity: NR | Primary outcome: Borderline symptoms on BPDSI-IV No difference between groups on BPD outcomes Attrition: 26.8% (19/71) G1: 31.9% (15/47) G2: 16.7% (4/24) | High |
Hilden et al. (2021) | Design: RCT Setting: Outpatient, single center Country: Finland Funding: Helsinki University Hospital | N = 42 G1 (14): TAU; psychiatrist visits and 45-minute therapy sessions once monthly; both pharmacotherapy and some form of psychosocial support or psychotherapy for most patients G2 (28): SFT; 20 weekly 90-minute sessions Duration: 20 weeks | Inclusion: Adults; BPD using DSM-IV SCID-II criteria (included those who had previously received treatment) Exclusion: Psychotic symptoms, suicide risk, principal diagnosis of uncontrollable SUD, or illness or symptoms affecting participation; those undergoing specific psychotherapy | Mean age, years (SD): G1: 27 (3.7) G2: 31 (8.8) Female: 83% Race/ethnicity: NR | Primary outcome: Intra-individual change in borderline personality symptoms No difference between groups on BPD outcomes Attrition: 16.7% (7/42) G1: 14.3% (2/14) G2: 17.97% (5/28) | Moderate |
Schema-Focused Therapy Versus Schema-Focused Therapy With Extra Phone Support
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Nadort et al. (2009) | Design: RCT Setting: Outpatient, multicenter Country: The Netherlands Funding: Other, public benefit organization | N = 62 G1 (30): 45-minute sessions of SFT twice a week in year 1 and once a week in year 2 G2 (32): 45-minute sessions of SFT twice a week along with extra phone support outside office hours Duration: 18 months | Inclusion: Ages 18–60 years; DSM-IV BPD diagnosis; BPDSI-IV score > 20 Exclusion: Psychotic disorders, bipolar disorder, DID, ASPD, or ADHD; addiction of such severity that clinical detoxification was indicated; psychiatric disorders secondary to medical conditions | Mean age, years (SD): G1: 32.13 (9.01) G2: 31.81 (9.24) Female: 96.8% Race/ethnicity: NR | Primary outcome: BPDSI-IV at 18 months No significant differences between G1 and G2 on BPD severity and burden as well as outcomes of global psychological problems, quality of life, and dysfunction Incidence of AEs: NR Withdrawal due to AEs: G1: 0% (0/30) G2: 3% (1/32; suicide after treatment allocation, but before treatment additional crisis support was provided) Attrition: 21% Differential attrition: ≤ 10 percentage points | Moderate |
Cognitive Rehabilitation Versus Psychoeducation
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Pascual et al. (2015) | Design: RCT Setting: Outpatient, multicenter Country: Spain Funding: Government, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Fondo de Investigación Sanitaria | N = 70 G1 (36): CR; twice-weekly group sessions G2 (34): Psychoeducation; weekly group sessions Duration: 16 weeks | Inclusion: Ages 18–45 years; outpatient; BPD diagnosis according to DSM-IV-TR and evaluated by SCID-II and DIB-R; CGI-BPD > 4; GAF < 65 Exclusion: Severe physical conditions that could affect neuropsychological performance; IQ < 85; MDD or substance misuse within past 6 months; schizophrenia, severe psychotic disorder, or bipolar disorder; previous participation in any psychoeducation or cognitive rehabilitation | Mean age, years (SD): G1: 32 (6.04) G2: 33 (8.8) Female: 74.3% Race/ethnicity: NR | Primary outcome: Psychosocial functioning at 6 months No significant difference between G1 and G2 on psychosocial functioning including on BSL-23, FAST, BIS, Ham-A, or MADRS at 6 months Incidence of AEs: NR Withdrawal due to AEs: NR Attrition: 40% Differential attrition: < 10 percentage points | High |
Cognitive Therapy Versus Rogerian Supportive Therapy
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Cottraux et al. (2009) | Design: RCT Setting: Outpatient, multicenter Country: France Funding: Other | N = 65 G1 (32): Weekly individual RST for 6 months then biweekly individual RST for 6 months G2 (33): Weekly individual CT for 6 months then biweekly individual RST for 6 months Duration: 1 year | Inclusion: DSM-IV BPD diagnosis (confirmed by DIB-R score of ≥ 8) Exclusion: Age < 18 or > 60 years; living too far from centers; psychotic disorders with current delusions; significant drug or alcohol addiction in foreground; antisocial behaviors; not following psychotherapy at time of the study | Mean age, years (SD): G1: 32.6 (8.3) G2: 34.3 (10.2) Female: 76.9% Race/ethnicity: NR | Primary outcome: Combined response (score ≤ 3 on CGI and Hopelessness score < 8) at 24 weeks No significant differences between G1 and G2 on CGI-I, Hopelessness scale, Ham-D, or BAI at 24 weeks G2 significant improvement in BDI scores at 24 weeks (13.0 vs. 21.7, P =0.01) Harms: NR Attrition: Week 24: 22% Week 104: 68% Differential attrition: ≤ 10 percentage points | Moderate |
Motive-Oriented Therapeutic Relationship Versus General Psychiatric Management
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Kramer et al. (2011) | Design: RCT Setting: Outpatient, single center Country: Switzerland Funding: NR | N = 25 G1 (14): 10 session TAU with manual-based psychiatric and psychotherapeutic approach G2 (11): 10 sessions of MOTR along with TAU Duration: Seven therapy sessions | Inclusion: Ages 16–60 years; DSM-IV BPD diagnosis; speaks fluent French Exclusion: Organic disorder or persistent substance abuse or dependence that might affect brain function; psychotic disorder implying pronounced break in reality testing, including schizophrenia, delusional disorder, and bipolar I disorder; acute risk of suicide; severe cognitive impairment | Mean age, years (SD): 31 (10.59) Female: 77% Race/ethnicity: NR | Primary outcome: Psychotherapeutic results on OQ–45 after seven therapy sessions No significant differences between G1 and G2 on psychotherapeutic results after seven therapy sessions Attrition: 42% Differential attrition: G1: 57% (8/14) G2: 18% (2/11) | High |
Kramer et al. (2014) | Design: RCT Setting: Outpatient, single center Country: Switzerland Funding: Government, Swiss National Science Foundation | N = 85 G1 (43): 10 sessions of GPM G2 (42): 10 sessions of GPM plus MOTR use of plan analysis Duration: 3 months | Inclusion: Ages 18–65 years; DSM-IV BPD diagnosis Exclusion: DSM-IV psychotic disorders, intellectual disability, or substance abuse | Mean age, years (SD): G1: 31 (11.00) G2: 35 (9.97) Female: 68.9% Race/ethnicity: NR | Primary outcome: Psychotherapeutic results on OQ-45 at 3 months G2 significantly greater improvement on OQ-45 at 3 months (76.0 vs. 86.1, P < 0.01) No significant differences between G1 and G2 on IIP and BSL at 3 months Attrition: 29% Differential attrition: ≤ 10 percentage points | Moderate |
Psychoanalytic-Interactional Therapy Versus Psychodynamic Therapy by Experts
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Leichsenring et al. (2016) | Design: RCT Setting: Inpatient, single center Country: Germany Funding: Other | N = 168 G1 (46): WL/TAU; 80% of patients continued usual treatment and remainder did not receive any treatment during WL period G2 (64): PIT; one or two weekly individual sessions and three weekly group therapy sessions; art or body therapy and consultations with a social worker (on needs basis) G3 (58): E-PDT; one or two weekly sessions of non-manualized individual therapy and three weekly sessions of group therapy; art or body therapy and consultations with a social worker (on needs basis) Mean duration, days (SD): G1: 89.69 (105.31) G2: 106.7 (41.71) G3: 76.78 (21.07) | Inclusion: Ages 18–65 years; Cluster B personality disorder diagnosis according to SCID-II (DSM-IV) Exclusion: Psychotic and acute substance-related disorders, acute (uncontrollable) risk of suicide, or organic mental disorders; severe medical conditions (according to ICD-10) | Mean age, years (SD): G1: 31 (9.4) G2: 29 (8.7) G3: 30 (9.1) Female: 69% Race/ethnicity: NR | Primary outcome: BPI, GSI of SCL-90-R at end of treatment (duration varies by treatment) G2 and G3 significantly more effective than G1 for improving BPD outcomes (measured by BPI [G2 vs. G1: 18.76 vs. 26.39, P = 0.004; G3 vs. G1: 19.41 vs. 26.39, P = 0.0004]), depression (BDI [G2 vs. G1: 17.44 vs. 27.80, P = 0.0001; G3 vs. G1: 15.20 vs. 27.80, P = 0.0001]), and global functioning (GSI of SCL-90-R [G2 vs. G1: 0.99 vs. 1.65, P = 0.0001; G3 vs. G1: 0.96 vs. 1.65, P = 0.0001]) No significant differences between active arms (G2 and G3) and G1 for anxiety (BAI) Incidence of AEs: NR Withdrawal due to AEs: NR Attrition: 18.0% (22/122) Differential attrition: ≤ 10 percentage points | High |
Mechanism-Based Group Psychotherapy Versus Nonspecific Supportive Psychotherapy
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Herpertz et al. (2020) | Design: RCT Setting: Outpatient, single center Country: Germany Funding: Other, German Research Foundation | N = 59 G1 (29): Mechanism-based anti-aggression psychotherapy; highly manualized program starting with one individual 1-hour session followed by 6 weeks of group therapy with two 1.5-hour sessions per week (a total of 18 hours) G2 (30): Nonspecific supportive psychotherapy similar to DBT with same dosage as G1 Duration: 6 months | Inclusion: Ages 18–55 years; outpatients meeting ≥ 4 BPD criteria according to IPDE Exclusion: Additional non-study psychotherapy; pregnancy; epilepsy; bipolar I disorder, schizophrenia, or current substance abuse or addiction as well as change in medication in past 3 weeks | Mean age, years (SD): G1: 33 (8.8) G2: 30 (9.5) Female: 64% Race/ethnicity: NR | Primary outcome: MOAS at 6 months No difference between groups at end of treatment G2 significantly greater improvement in overt aggression on the MOAS at 6 months (10.60 vs. 22.95, P = 0.02) Incidence of AEs: G1: 6.9% (2/29) G2: 0% (0/30) Withdrawal due to AE: G1: 3.4% (1/29) G2: 0% (0/30) Attrition: 24% Differential attrition: ≥ 10 percentage points G1: 31% (9/29) G2: 17% (5/30) | High |
Other Psychotherapy Versus Treatment as Usual
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Amianto et al. (2011) | Design: RCT Setting: Outpatient, single center Country: Italy Funding: Government, other | N = 35 G1 (17): TAU: Supervised team management G2 (18): Supervised team management plus sequential brief Adlerian psychodynamic psychotherapy Duration: 12 months | Inclusion: Ages 20–50 years; DSM-IV-TR BPD diagnosis; heavy use of MHS throughout prior year Exclusion: Acute comorbid Axis I disorder requiring hospitalization; current SUD; intellectual disability; previous psychotherapy interventions | Mean age, years (SD): 40 (9.4) Female: 49% Race/ethnicity: NR | Primary outcome: High mental health use (more than six emergency interventions in prior year) No significant differences between G2 and G1 in CGI, SCL-90, and GAF at 12 months Attrition: 5.7% (2/35) G1: 5.9% (1/17) G2: 5.6% (1/18) | Moderate |
Gratz et al. (2014) | Design: RCT Setting: Outpatient, single center Country: NR Funding: Government, NIMH | N = 61 G1 (30): TAU; ongoing outpatient treatment, with most participants (> 70%) receiving supportive or dynamic individual therapy and others (19%) receiving CBT G2 (31): ERGT; Weekly 90-minute group sessions over 14 weeks (six patients per group) Duration: 14 weeks | Inclusion: Females; age 18–60 years; threshold or subthreshold diagnosis of BPD; history of repeated deliberate self-harm, with one or more episodes in past 6 months; having an individual therapist, psychiatrist, or case manager; diagnostic interview for DSM-IV Exclusion: Diagnoses of primary psychotic disorder, bipolar I disorder, or current (past month) SUD | Mean age, years (SD): G1: 33 (0.9) G2: 33 (11.0) Female: 100% Race/ethnicity: Racial/ethnic minority: 21% | Primary outcome: NR G2 significantly more effective than G1 for improving self-harm (measured using SHI; 16.05 vs. 29.40, P < 0.05), emotion dysregulation (DERS; 95.27 vs. 113.62, P < 0.05), BPD severity (ZAN-BPD; 4.35 vs. 12.03, P < 0.05), and quality of life (QLI; 0.31 vs. - 0.50, P < 0.05) No significant differences between G2 and G1 on measures of BPD-related severity and symptoms (measured by composite of IIP, BEST, AAQ, BDI, and SDS) Attrition: 13.1% (8/61) G1: 10% (3/30) G2: 16.1% (5/31) | Moderate |
Reneses et al. (2013) | Design: RCT Setting: Outpatient, multicenter Country: Spain Funding: Government, Ministry | N = 53 G1 (28): TAU; conventional treatment without specific additional psychotherapy for 6 months, psychopharmacological treatment in accordance with standard applied in hospital clinic G2 (25): PRFP along with conventional care: 20 face-to-face, 45-minute, consecutive weekly PRFP sessions plus conventional outpatient psychiatric treatment Duration: 12 months | Inclusion: Ages 18–50 years; clinical diagnosis of BPD using DSM-IV-TR and SCID-II; clinical situation of outpatient treatment Exclusion: Active suicide risk symptoms, violent or unmanageable heteroaggressive behaviors; comorbidity with diagnosis of eating behavior disorder on Axis I, toxic dependence disorder, or current severe physical disease; interrupting patients’ psychotherapy for more than four consecutive sessions without justification or for more than six sessions in any case | Mean age, years (SD): 34 (7.5) Female: 71% Race/ethnicity: NR | Primary outcome: Severity of general symptoms (GSI of SCL-90-R) and impulsivity (BIS, SASS) G2 significantly more effective than G1 for improving BPD severity (measured by ZAN-BPD; 13.0 vs. 19.1, P < 0.001) and symptoms (SCL-90 [1.2 vs. 1.7, P < 0.001]; MADRS total [15.9 vs. 22.8, P < 0.001]; BIS [52.5 vs. 68.2, P < 0.01]; and SASS [35.4 vs. 27.6, P < 0.001]) No significant differences between G2 and G1 for STAI state score or CGI Attrition: 13% (7/53) G1: 14% (4/28) G2: 12% (3/25) | High |
Leichsenring et al. (2016) | Design: RCT Setting: Inpatient, single center Country: Germany Funding: Other | N = 168 G1 (46): WL/TAU; 80% of patients continued usual treatment and remainder did not receive any treatment during WL period G2 (64): PIT; one or two weekly individual sessions and three weekly group therapy sessions; art or body therapy and consultations with a social worker (on needs basis) G3 (58): E-PDT; one or two weekly sessions of non-manualized individual therapy and three weekly sessions of group therapy; art or body therapy and consultations with a social worker (on needs basis) Mean duration, days (SD): G1: 89.69 (105.31) G2: 106.7 (41.71) G3: 76.78 (21.07) | Inclusion: Ages 18–65 years; Cluster B personality disorder diagnosis according to SCID-II (DSM-IV) Exclusion: Psychotic and acute substance-related disorders, acute (uncontrollable) risk of suicide, or organic mental disorders; severe medical conditions (according to ICD-10) | Mean age, years (SD): G1: 31 (9.4) G2: 29 (8.7) G3: 30 (9.1) Female: 69% Race/ethnicity: NR | Primary outcome: BPI, GSI of SCL-90-R at end of treatment (duration varies by treatment) G2 and G3 significantly more effective than G1 for improving BPD outcomes (measured by BPI [G2 vs. G1: 18.76 vs. 26.39, P = 0.004; G3 vs. G1: 19.41 vs. 26.39, P = 0.0004]), depression (BDI [G2 vs. G1: 17.44 vs. 27.80, P = 0.0001; G3 vs. G1: 15.20 vs. 27.80, P = 0.0001]) and global functioning (GSI of SCL-90-R [G2 vs. G1: 0.99 vs. 1.65, P = 0.0001; G3 vs. G1: 0.96 vs. 1.65, P = 0.0001]) No significant differences between active arms (G2 and G3) and G1 for anxiety (BAI) Incidence of AEs: NR Withdrawal due to AEs: NR Attrition: 18.0% (22/122) Differential attrition: ≤ 10 percentage points | High |
Service Delivery Approaches
Author (year) and/or trial name | Study characteristics | Participants, N; interventions; duration | Study population, including main inclusion and exclusion criteria | Sample demographics | Primary outcome; main results; attrition | Risk of bias |
---|---|---|---|---|---|---|
Bartak et al. (2011) | Design: Prospective cohort study Setting: University hospital and mental health care centers Country: The Netherlands Funding: None | N = 245 G1 (59): Outpatient individual or group psychotherapy sessions for up to two sessions per week G2 (99): At least one session per week of psychotherapy in day-hospital but slept at home G3 (87): Stayed at institution for 5 days per week and received different forms of psychotherapy Duration: 18 months | Inclusion: Participants with Cluster B personality disorders diagnosed with DSM-IV Personality Exclusion: Organic cerebral impairment, intellectual disability, or schizophrenia | Based on N analyzed: Mean age, years (SD): 31 (8.5) Female: 71% Race/ethnicity: NR 77% with BPD | Primary outcome: GSI at 18 months No significant differences in GSI and EQ-5D Incidence of AEs: NR Withdrawal due to AEs: NR Attrition: 16% Differential attrition: ≤ 10 percentage points | Moderate |
Laporte et al. (2018) | Design: Prospective cohort Setting: Outpatient, multicenter Country: Canada Funding: McGill University | N = 681 G1 (479): 12 weekly sessions of individual therapy and 12 of group therapy G2 (138): Extended care clinic with weekly sessions of two types of group therapy, weekly sessions of individual therapy, and pharmacological management Duration: G1: 12 weeks G2: 6–24 months | Inclusion: DSM-5 BPD diagnosis; ≥ 8 on DIB-R for current BPD Exclusion: NR | Mean age, years (SD): G1: 27 (7.8) G2: 36 (10.4) Female: 93% Race/ethnicity: NR | Primary outcome: NR Significant reductions in both groups but no reporting on between-group comparisons Incidence of AEs: NR Withdrawal due to AEs: NR Attrition: 32% Differential attrition: G1: 29% (137/479) G2: 43% (59/138) | High |
Sinnaeve et al. (2018) | Design: RCT Setting: Community mental health centers Country: The Netherlands Funding: GGZ Rivierduinen | N = 84 G1 (42): Standard, outpatient DBT G2 (42): Step-down DBT consisting of 3 months of residential DBT plus 6 months of outpatient DBT Duration: G1: 12 months G2: 9 months | Inclusion: DSM-IV BPD diagnosis; ages 18–45 years; ≥ 24 on the BPDSI-IV and one or more episodes of SIB Exclusion: Chronic psychotic disorder, bipolar I disorder, intellectual disability, or SUD requiring detoxification; involuntary psychiatric treatment | Mean age, years (SD): G1: 26 (7.5) G2: 26 (6.2) Female: 95% Race/ethnicity: NR | Primary outcome: NR Significant reductions in both groups but no reporting on between-group comparisons Incidence of AEs: NR Withdrawal due to AEs: NR Attrition: 44% Differential attrition: ≤ 10 percentage points | High |
Smits et al. (2020; 2022) | Design: RCT Setting: Outpatient, multicenter Country: The Netherlands Funding: ZonMw | N = 114 G1 (70): MBT, day-hospital setting G2 (44): MBT, IOP setting Duration: 18 months | Inclusion: BPD diagnosis; age ≥ 18 years Exclusion: ASD, chronic psychotic disorder, or organic brain disorder, intellectual disability (IQ < 80), or ASPD with history of physical violence | Mean age, years (SD): G1: 31 (10.6) G2: 30 (9.2) Female: 83% Race/ethnicity: NR | Primary outcome: GSI of BSI at 18 months Significant improvements on all outcomes (GSI, SSHI, PAI-BOR, EQ-5D, IIP, SIPP) at 18 months and no significant between-group difference except on IIP and SIPP No significant differences between groups at 36 months Incidence of AEs: NR Withdrawal due to AEs: NR Attrition: 78% at 18 months Differential attrition: 18% | High |
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