Systematic review of psychotherapeutic treatments for “minor” personality disorders

IntroductionAmong personality disorders (PDs), antisocial and borderline personality disorder are well-studied. However, the remaining PDs (in the following called “minor PDs”) pose major problems in everyday-health care settings. People affected often present with additional axis-I disorders such as substance-related, mood or anxiety disorders, and are among those most difficult to treat.ObjectivesTo systematically review the current evidence of psychotherapeutic treatments for “minor” personality disordersMethodsIn the context of Cochrane Collaboration reviews for Cluster A, B and C PDs, exhaustive literature searches were done to identify the current RCT evidence for PD treatments. The electronic search strategies were extended to identify also non-RCT evidence for minor PD treatments. Retrievals were assessed and evaluated by two reviewers independently.ResultsThe current evidence for psychotherapeutic treatments of minor PDs is sparse and based on mixed PD samples with co-morbid axis-I disorders in the majority of cases. Reported outcomes focus on specific axis-I disorders or general measures such as overall functioning.ConclusionsThe current evidence is scarce and does not allow for distinct treatment recommendations but undermines the importance of meeting special demands of PD patients by PD-specific treatments. Possible reasons for the paucity of research in this regard will be discussed, also in the light of future developments after DSM-V.