Jennifer Wong1, Anees Bahji1,2, Sarosh Khalid-Khan1,3. 1. Department of Psychiatry, Queen's University, Kingston, Ontario, Canada. 2. Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada. 3. Division of Child and Youth Mental Health, Queen's University, Kingston, Ontario, Canada.
Abstract
BACKGROUND: Evidence regarding the efficacy of psychotherapy in adolescents with borderline personality disorder (BPD) symptomatology has not been previously synthesized. OBJECTIVE: To conduct a systematic review and meta-analysis of the randomized controlled trials (RCTs) in order to assess the efficacy of psychotherapies in adolescents with BPD symptomatology. METHODS: Seven electronic databases were systematically searched using the search terms BPD, adolescent, and psychotherapy from database inception to July 2019. Titles/abstracts and full-texts were screened by one reviewer; discrepancies were resolved via consensus. We extracted data on BPD symptomatology, including BPD symptoms, suicide attempts, nonsuicidal self-injury, general psychopathology, functional recovery, and treatment retention. Data were pooled using random-effects models. RESULTS: Of 536 papers, seven trials (643 participants) were eligible. Psychotherapy led to significant short-term improvements in BPD symptomatology posttreatment (g = -0.89 [-1.75, -0.02]) but not in follow-up (g = 0.06 [-0.26, 0.39]). There was no significant difference in treatment retention between the experimental and control groups overall (odds ratio [OR] 1.02, 95% confidence interval [CI], 0.92 to 1.12, I 2 = 52%). Psychotherapy reduced the frequency of nonsuicidal self-injury (OR = 0.34, 95% CI, 0.16 to 0.74) but not suicide attempts (OR = 1.03, 95% CI, 0.46 to 2.30). CONCLUSIONS: There is a growing variety of psychotherapeutic interventions for adolescents with BPD symptomatology that appears feasible and effective in the short term, but efficacy is not retained in follow-up-particularly for frequency of suicide attempts.
BACKGROUND: Evidence regarding the efficacy of psychotherapy in adolescents with borderline personality disorder (BPD) symptomatology has not been previously synthesized. OBJECTIVE: To conduct a systematic review and meta-analysis of the randomized controlled trials (RCTs) in order to assess the efficacy of psychotherapies in adolescents with BPD symptomatology. METHODS: Seven electronic databases were systematically searched using the search terms BPD, adolescent, and psychotherapy from database inception to July 2019. Titles/abstracts and full-texts were screened by one reviewer; discrepancies were resolved via consensus. We extracted data on BPD symptomatology, including BPD symptoms, suicide attempts, nonsuicidal self-injury, general psychopathology, functional recovery, and treatment retention. Data were pooled using random-effects models. RESULTS: Of 536 papers, seven trials (643 participants) were eligible. Psychotherapy led to significant short-term improvements in BPD symptomatology posttreatment (g = -0.89 [-1.75, -0.02]) but not in follow-up (g = 0.06 [-0.26, 0.39]). There was no significant difference in treatment retention between the experimental and control groups overall (odds ratio [OR] 1.02, 95% confidence interval [CI], 0.92 to 1.12, I 2 = 52%). Psychotherapy reduced the frequency of nonsuicidal self-injury (OR = 0.34, 95% CI, 0.16 to 0.74) but not suicide attempts (OR = 1.03, 95% CI, 0.46 to 2.30). CONCLUSIONS: There is a growing variety of psychotherapeutic interventions for adolescents with BPD symptomatology that appears feasible and effective in the short term, but efficacy is not retained in follow-up-particularly for frequency of suicide attempts.
Entities:
Keywords:
child and adolescent psychiatry; personality disorder; psychotherapy
Authors: Andrew M Chanen; Henry J Jackson; Louise K McCutcheon; Martina Jovev; Paul Dudgeon; Hok Pan Yuen; Dominic Germano; Helen Nistico; Emma McDougall; Caroline Weinstein; Verity Clarkson; Patrick D McGorry Journal: Br J Psychiatry Date: 2008-12 Impact factor: 9.319
Authors: Elizabeth McCauley; Michele S Berk; Joan R Asarnow; Molly Adrian; Judith Cohen; Kathyrn Korslund; Claudia Avina; Jennifer Hughes; Melanie Harned; Robert Gallop; Marsha M Linehan Journal: JAMA Psychiatry Date: 2018-08-01 Impact factor: 21.596
Authors: Lars Mehlum; Anita J Tørmoen; Maria Ramberg; Egil Haga; Lien M Diep; Stine Laberg; Bo S Larsson; Barbara H Stanley; Alec L Miller; Anne M Sund; Berit Grøholt Journal: J Am Acad Child Adolesc Psychiatry Date: 2014-07-22 Impact factor: 8.829
Authors: Julian P T Higgins; Douglas G Altman; Peter C Gøtzsche; Peter Jüni; David Moher; Andrew D Oxman; Jelena Savovic; Kenneth F Schulz; Laura Weeks; Jonathan A C Sterne Journal: BMJ Date: 2011-10-18
Authors: Andrew M Chanen; Jennifer K Betts; Henry Jackson; Sue M Cotton; John Gleeson; Christopher G Davey; Katherine Thompson; Sharnel Perera; Victoria Rayner; Sinn Yuin Chong; Louise McCutcheon Journal: Can J Psychiatry Date: 2021-02-12 Impact factor: 5.321
Authors: Mie Sedoc Jørgensen; Ole Jakob Storebø; Jutta M Stoffers-Winterling; Erlend Faltinsen; Adnan Todorovac; Erik Simonsen Journal: PLoS One Date: 2021-01-14 Impact factor: 3.240
Authors: Katrina G Witt; Sarah E Hetrick; Gowri Rajaram; Philip Hazell; Tatiana L Taylor Salisbury; Ellen Townsend; Keith Hawton Journal: Cochrane Database Syst Rev Date: 2021-03-07
Authors: Aishah Snoek; Aartjan T F Beekman; Jack Dekker; Inga Aarts; Gerard van Grootheest; Matthijs Blankers; Chris Vriend; Odile van den Heuvel; Kathleen Thomaes Journal: BMC Psychiatry Date: 2020-08-06 Impact factor: 3.630