DBT Therapy is an Effective Treatment for BPD

The majority of those with borderline personality disorder (BPD) experience difficulty regulating their thoughts and emotions, often demonstrating impulsive behavior such as suicidality. While some individuals with BPD can be high functioning in certain settings, such as work, they frequently struggle with aspects of social functioning in their private lives. With symptoms usually beginning in adolescence or early adulthood, the adverse effects of BPD occur primarily in the context of relationships.

An estimated 69%–80% of patients coping with BPD attempt suicide, and an even greater percentage engage in non-suicidal, self-injurious behavior. Approximately 10% of those with BPD who attempt suicide are successful. In addition to BPD’s considerable injury and mortality rates, the illness often results in substantial costs through the need for extensive health care utilization such as emergency room visits, inpatient days, and psychotropic medication use.

Once deemed virtually impossible to effectively remediate, BPD is now acknowledged as a treatable personality disorder, with new approaches offering significant hope to those diagnosed with the mental health illness.

In the past decade, several studies have shown the effectiveness of various types of psychotherapy in reducing the negative effects of BPD. One such study, the Hunter DBT Project, set out to determine the efficacy of dialectical behavior therapy in women with borderline personality disorder. In the study, 73 female subjects meeting criteria for BPD were subjected to either DBT intervention or the control condition, which was treatment as usual (basic psychotherapy) plus waiting list for DBT.

After 6 months, findings determined that both groups experienced a similar rate of reduction in deliberate self-harm (DSH), hospitalizations, hospital admissions, or length of stay in hospital. However, when evaluating disability (days spent in bed) and quality of life (physical, psychological, and environmental domains), those in the DBT group showed noticeable improvements, benefiting over those in the control group who had not received DBT.

Another DBT study, that pitted DBT against general psychiatric management for the treatment for BPD had similar encouraging findings. Here, 180 patients diagnosed with borderline personality disorder who had at least two suicidal or non-suicidal self-injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. Once again, DBT proved to be a highly effective treatment approach for the BPD population.

Along with significant reductions in the frequency and severity of suicidal and non-suicidal self-injurious episodes, those treated with DBT showed substantial improvements in most secondary clinical outcomes; recipients of DBT required less general health care utilization, such as emergency visits and psychiatric hospital days. In addition, considerable improvements were seen in common BPD symptoms such as negative interpersonal functioning, anger, and depression.

While those in the group receiving general psychiatric management elicited equally encouraging findings, the results of the study suggest that individuals with borderline personality disorder now have promising choices for viable and effective treatment options that offer hope for a better quality of life.