Favourable outcome of long-term combined psychotherapy for patients with borderline personality disorder: Six-year follow-up of a randomized study

BackgroundLonger-term follow-up of patients with borderline personality disorder have found favourable clinical outcomes, with long-term reduction in symptoms and diagnosis.AimsWe examined the 6-year outcome of patients with borderline personality disorder who were randomised to 1 year of cognitive–behavioural therapy for personality disorders (CBT–PD) or treatment as usual (TAU) in the BOSCOT trial, in three centres across the UK (trial registration: ISRCTN86177428).MethodIn total, 106 participants met criteria for borderline personality disorder in the original trial. Patients were interviewed at follow-up by research assistants masked to the patient's original treatment group, CBT–PD or TAU, using the same measures as in the original randomised trial. Statistical analyses of data for the group as a whole are based on generalised linear models with repeated measures analysis of variance type models to examine group differences.ResultsFollow-up data were obtained for 82% of patients at 6 years. Over half the patients meeting criteria for borderline personality disorder at entry into the study no longer did so 6 years later. The gains of CBT–PD over TAU in reduction of suicidal behaviour seen after 1-year follow-up were maintained. Length of hospitalisation and cost of services were lower in the CBT–PD group compared with the TAU group.ConclusionsAlthough the use of CBT–PD did not demonstrate a statistically significant cost-effective advantage, the findings indicate the potential for continued long-term cost-offsets that accrue following the initial provision of 1 year of CBT–PD. However, the quality of life and affective disturbance remained poor.

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Ten-Year Course of Borderline Personality Disorder

10.1093/med/9780190625085.003.0033 ◽

2018 ◽

Author(s):

Kevin Johnson ◽

Erica Robinson ◽

Sarah Fineberg

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Clinical Case ◽

Borderline Personality ◽

Major Depressive ◽

Long Term Prognosis ◽

Study Intervention ◽

Landmark Study

This chapter provides a summary of a landmark study on borderline personality disorder. What is the long-term prognosis of those with borderline personality disorder (BPD) compared to those with major depressive disorder or other personality disorders? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The findings show a favorable long-term prognosis that is comparable to that of other psychiatric disorders; 85% of those with BPS show at least 12-months of continuous remission after ten years. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

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Long-Term Course of Borderline Personality Disorder: A Prospective 10-Year Follow-Up Study

Journal of Personality Disorders ◽

10.1521/pedi_2016_30_269 ◽

2017 ◽

Vol 31 (5) ◽

pp. 590-605 ◽

Cited By ~ 16

Author(s):

Irene Alvarez-Tomás ◽

Joaquim Soler ◽

Arturo Bados ◽

Ana Martín-Blanco ◽

Matilde Elices ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Follow Up Study

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Abandonment Psychotherapy and Psychosocial Functioning Among Suicidal Patients With Borderline Personality Disorder: A 3-Year Naturalistic Follow-Up

Journal of Personality Disorders ◽

10.1521/pedi_2019_33_423 ◽

2019 ◽

pp. 1-11

Author(s):

Antonio Andreoli ◽

Yvonne Burnand ◽

Laura Frambati ◽

Donna Manning ◽

Allen Frances

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Psychosocial Functioning ◽

Randomized Study ◽

Borderline Personality ◽

Psychotic Symptoms ◽

Global Functioning ◽

Treatment As Usual ◽

Treatment Conditions

The authors present the results from a 3-year follow-up among 170 patients who had participated in the original randomized study, which consisted of three treatment conditions: (a) 3-month abandonment psychotherapy (AP) delivered by certified psychotherapists, (b) AP delivered by nurses, and (c) treatment as usual in a psychiatric crisis center. All subjects were recruited at the emergency room after a suicide attempt and met diagnostic criteria for borderline personality disorder and major depression. Psychotic symptoms, bipolar disorder, and mental retardation were exclusion criteria. At 3-year follow-up, 134 (78.8%) subjects had blind, reliable assessment by clinical psychologists. The intent-to-treat analysis indicated that those patients who had received AP during acute treatment had better global functioning, improved work adjustment, and less unemployment/disability at 3-year follow-up. No differences were found as a function of type of therapist delivering AP. The data confirm that short-term AP gains in psychosocial functioning are sustained over the longer term.

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