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Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis

A broad range of psychotherapies have been proposed and evaluated in the treatment of borderline personality disorder (BPD), but the question which specific type of psychotherapy is most effective remains unanswered. In this study, two network meta-analyses (NMAs) were conducted investigating the co...

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Autores principales: Setkowski, Kim, Palantza, Christina, van Ballegooijen, Wouter, Gilissen, Renske, Oud, Matthijs, Cristea, Ioana A., Noma, Hisashi, Furukawa, Toshi A., Arntz, Arnoud, van Balkom, Anton J. L. M., Cuijpers, Pim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277776/
https://www.ncbi.nlm.nih.gov/pubmed/37203447
http://dx.doi.org/10.1017/S0033291723000685
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author Setkowski, Kim
Palantza, Christina
van Ballegooijen, Wouter
Gilissen, Renske
Oud, Matthijs
Cristea, Ioana A.
Noma, Hisashi
Furukawa, Toshi A.
Arntz, Arnoud
van Balkom, Anton J. L. M.
Cuijpers, Pim
author_facet Setkowski, Kim
Palantza, Christina
van Ballegooijen, Wouter
Gilissen, Renske
Oud, Matthijs
Cristea, Ioana A.
Noma, Hisashi
Furukawa, Toshi A.
Arntz, Arnoud
van Balkom, Anton J. L. M.
Cuijpers, Pim
author_sort Setkowski, Kim
collection PubMed
description A broad range of psychotherapies have been proposed and evaluated in the treatment of borderline personality disorder (BPD), but the question which specific type of psychotherapy is most effective remains unanswered. In this study, two network meta-analyses (NMAs) were conducted investigating the comparative effectiveness of psychotherapies on (1) BPD severity and (2) suicidal behaviour (combined rate). Study drop-out was included as a secondary outcome. Six databases were searched until 21 January 2022, including RCTs on the efficacy of any psychotherapy in adults (⩾18 years) with a diagnosis of (sub)clinical BPD. Data were extracted using a predefined table format. PROSPERO ID:CRD42020175411. In our study, a total of 43 studies (N = 3273) were included. We found significant differences between several active comparisons in the treatment of (sub)clinical BPD, however, these findings were based on very few trials and should therefore be interpreted with caution. Some therapies were more efficacious compared to GT or TAU. Furthermore, some treatments more than halved the risk of attempted suicide and committed suicide (combined rate), reporting RRs around 0.5 or lower, however, these RRs were not statistically significantly better compared to other therapies or to TAU. Study drop-out significantly differed between some treatments. In conclusion, no single treatment seems to be the best choice to treat people with BPD compared to other treatments. Nevertheless, psychotherapies for BPD are perceived as first-line treatments, and should therefore be investigated further on their long-term effectiveness, preferably in head-to-head trials. DBT was the best connected treatment, providing solid evidence of its effectiveness.
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spelling pubmed-102777762023-06-20 Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis Setkowski, Kim Palantza, Christina van Ballegooijen, Wouter Gilissen, Renske Oud, Matthijs Cristea, Ioana A. Noma, Hisashi Furukawa, Toshi A. Arntz, Arnoud van Balkom, Anton J. L. M. Cuijpers, Pim Psychol Med Review Article A broad range of psychotherapies have been proposed and evaluated in the treatment of borderline personality disorder (BPD), but the question which specific type of psychotherapy is most effective remains unanswered. In this study, two network meta-analyses (NMAs) were conducted investigating the comparative effectiveness of psychotherapies on (1) BPD severity and (2) suicidal behaviour (combined rate). Study drop-out was included as a secondary outcome. Six databases were searched until 21 January 2022, including RCTs on the efficacy of any psychotherapy in adults (⩾18 years) with a diagnosis of (sub)clinical BPD. Data were extracted using a predefined table format. PROSPERO ID:CRD42020175411. In our study, a total of 43 studies (N = 3273) were included. We found significant differences between several active comparisons in the treatment of (sub)clinical BPD, however, these findings were based on very few trials and should therefore be interpreted with caution. Some therapies were more efficacious compared to GT or TAU. Furthermore, some treatments more than halved the risk of attempted suicide and committed suicide (combined rate), reporting RRs around 0.5 or lower, however, these RRs were not statistically significantly better compared to other therapies or to TAU. Study drop-out significantly differed between some treatments. In conclusion, no single treatment seems to be the best choice to treat people with BPD compared to other treatments. Nevertheless, psychotherapies for BPD are perceived as first-line treatments, and should therefore be investigated further on their long-term effectiveness, preferably in head-to-head trials. DBT was the best connected treatment, providing solid evidence of its effectiveness. Cambridge University Press 2023-06 2023-05-19 /pmc/articles/PMC10277776/ /pubmed/37203447 http://dx.doi.org/10.1017/S0033291723000685 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Review Article
Setkowski, Kim
Palantza, Christina
van Ballegooijen, Wouter
Gilissen, Renske
Oud, Matthijs
Cristea, Ioana A.
Noma, Hisashi
Furukawa, Toshi A.
Arntz, Arnoud
van Balkom, Anton J. L. M.
Cuijpers, Pim
Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis
title Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis
title_full Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis
title_fullStr Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis
title_full_unstemmed Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis
title_short Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis
title_sort which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? a systematic review and network meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277776/
https://www.ncbi.nlm.nih.gov/pubmed/37203447
http://dx.doi.org/10.1017/S0033291723000685
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