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Cited by 655Personality Disorders and PsychopathologyPsychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology Research

Efficacy of Psychotherapies for Borderline Personality Disorder: A Systematic Review and Meta-analysis

Open access
Cristea, Ioana A., Gentili, Claudio, Cotet, Carmen D., Palomba, Daniela, Barbui, Corrado, Cuijpers, Pim·2017·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2016.4287
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Abstract

IMPORTANCE: Borderline personality disorder (BPD) is a debilitating condition, but several psychotherapies are considered effective. OBJECTIVE: To conduct an updated systematic review and meta-analysis of randomized clinical trials to assess the efficacy of psychotherapies for BPD populations. DATA SOURCES: Search terms were combined for borderline personality and randomized trials in PubMed, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials (from database inception to November 2015), as well as the reference lists of earlier meta-analyses. STUDY SELECTION: Included were randomized clinical trials of adults with diagnosed BPD randomized to psychotherapy exclusively or to a control intervention. Study selection differentiated stand-alone designs (in which an independent psychotherapy was compared with control interventions) from add-on designs (in which an experimental intervention added to usual treatment was compared with usual treatment alone). DATA EXTRACTION AND SYNTHESIS: Data extraction coded characteristics of trials, participants, and interventions and assessed risk of bias using 4 domains of the Cochrane Collaboration Risk of Bias tool (independent extraction by 2 assessors). Outcomes were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted. MAIN OUTCOMES AND MEASURES: Standardized mean differences (Hedges g) were calculated using all outcomes reported in the trials for borderline symptoms, self-harm, suicide, health service use, and general psychopathology at posttest and follow-up. Differential treatment retention at posttest was analyzed, reporting odds ratios. RESULTS: Thirty-three trials (2256 participants) were included. For borderline-relevant outcomes combined (symptoms, self-harm, and suicide) at posttest, the investigated psychotherapies were moderately more effective than control interventions in stand-alone designs (g = 0.32; 95% CI, 0.14-0.51) and add-on designs (g = 0.40; 95% CI, 0.15-0.65). Results were similar for other outcomes, including stand-alone designs: self-harm (g = 0.32; 95% CI, 0.09-0.54), suicide (g = 0.44; 95% CI, 0.15-0.74), health service use (g = 0.40; 95% CI, 0.22-0.58), and general psychopathology (g = 0.32; 95% CI, 0.09-0.55), with no differences between design types. There were no significant differences in the odds ratios for treatment retention (1.32; 95% CI, 0.87-2.00 for stand-alone designs and 1.01; 95% CI, 0.55-1.87 for add-on designs). Thirteen trials reported borderline-relevant outcomes at follow-up (g = 0.45; 95% CI, 0.15-0.75). Dialectical behavior therapy (g = 0.34; 95% CI, 0.15-0.53) and psychodynamic approaches (g = 0.41; 95% CI, 0.12-0.69) were the only types of psychotherapies more effective than control interventions. Risk of bias was a significant moderator in subgroup and meta-regression analyses (slope β = -0.16; 95% CI, -0.29 to -0.03; P = .02). Publication bias was persistent, particularly for follow-up. CONCLUSIONS AND RELEVANCE: Psychotherapies, most notably dialectical behavior therapy and psychodynamic approaches, are effective for borderline symptoms and related problems. Nonetheless, effects are small, inflated by risk of bias and publication bias, and particularly unstable at follow-up.

AI snapshot

Written from the paper’s full text.

TL;DR

This updated systematic review and meta-analysis of 33 RCTs (2256 adults with BPD) found that psychotherapies produced small posttest benefits over control for borderline-relevant outcomes (all trials g=0.35; 95% CI, 0.20-0.50), with dialectical behavior therapy and psychodynamic approaches effective. Effects were attenuated by risk of bias and publication bias and became unstable/nonsignificant at follow-up after adjustment.

Key findings

  • Across 33 trials (2256 participants), posttest borderline-relevant outcomes favored psychotherapy: stand-alone designs g=0.32 (95% CI, 0.14-0.51); add-on designs g=0.40 (95% CI, 0.15-0.65); all trials combined g=0.35 (95% CI, 0.20-0.50; 27 trials).
  • In stand-alone designs, effects were significant for self-harm g=0.32 (95% CI, 0.09-0.54), suicide g=0.44 (95% CI, 0.15-0.74), health service use g=0.40 (95% CI, 0.22-0.58), and general psychopathology g=0.32 (95% CI, 0.09-0.55); treatment retention was not significantly different (OR, 1.32; 95% CI, 0.87-2.00 for stand-alone; OR, 1.01; 95% CI, 0.55-1.87 for add-on).
  • Only DBT (g=0.34; 95% CI, 0.15-0.53) and psychodynamic approaches (g=0.41; 95% CI, 0.12-0.69) were significantly more effective than control; CBT (g=0.24; 95% CI, -0.01 to 0.49) and other interventions (g=0.38; 95% CI, -0.15 to 0.92) were not.
  • Follow-up effects were significant across 13 trials (g=0.45; 95% CI, 0.15-0.75), but risk of bias moderated outcomes (slope β=-0.16; 95% CI, -0.29 to -0.03; P=.02), with low-RoB trials (3-4 domains) showing g=0.11 (95% CI, -0.12 to 0.35) versus g=0.48 (95% CI, 0.33-0.64) for 0-2 domains (P=.01); trim-and-fill reduced posttest g from 0.35 to 0.23 (95% CI, 0.07-0.38) and made follow-up nonsignificant (g=0.19; 95% CI, -0.15 to 0.53).

Methods

  • Systematic review and meta-analysis of RCTs identified from PubMed, PsycINFO, EMBASE, and Cochrane Central Register of Controlled Trials (inception to November 2015) plus reference lists; included adults with diagnosed BPD randomized to psychotherapy exclusively or to a control intervention, excluding adolescent/partially adolescent samples, head-to-head comparisons of BPD-specific therapies, and trials with standardized combined medication protocols.
  • Included 33 trials (2256 participants; 1169 treatment, 1087 control): 22 stand-alone and 11 add-on designs; DBT (12 trials), psychodynamic (8), CBT (5); control was TAU in 21 trials and manualized in 10; treatment developer was an author in 20 trials.
  • Random-effects meta-analysis calculated Hedges g for outcome categories at posttest and follow-up, odds ratios for treatment retention, subgroup and meta-regression analyses, Cochrane risk-of-bias assessment across 4 domains, and publication-bias assessment via funnel plots, trim-and-fill, and Egger test.

Limitations

  • Stated in the paper: some outcome categories or subgroups included few trials; 5 trials lacked data needed for effect-size calculation; most trials were not registered, so selective outcome reporting could not be rated; the search may have missed trials; therapies were grouped into broad categories, effacing subtler differences; schema-focused therapy was underrepresented; and adjunct medication use was neither standardized nor consistently reported.
  • Stated in the paper: effects were small, inflated by publication bias, and particularly unstable at follow-up; effects were no longer sustained in trials with low risk of bias.
  • Evident from the text: heterogeneity was moderate to high across many analyses (e.g., 70% for all-trial follow-up borderline-relevant outcomes and 79% for add-on follow-up), and several key findings rested on small numbers of trials, making some estimates tentative.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1001/jamapsychiatry.2016.4287

Cites

70 of 70 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 27 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In stand-alone designs at posttest, psychotherapy was more effective than control for health service use, with g = 0.40 (95% CI, 0.22-0.58).

    “health service use (g = 0.40; 95% CI, 0.22-0.58),”
    Quote in the paperSubstantial claim
  • Findingown data

    Treatment retention did not differ significantly between psychotherapy and control in add-on designs (OR 1.01; 95% CI, 0.55-1.87).

    “and 1.01; 95% CI, 0.55-1.87for add-on designs).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Treatment retention is a valid indicator of treatment acceptability or effectiveness.
  • Findingown data

    There were no differences between stand-alone and add-on design types on the outcome categories.

    “with no differences between design types.”
    • Also stated in: § All Trials · plain
      “There were no significant differences between the 2 design types on any of the symptom outcome categories or on treatment retention.”
    Quote in the paperSubstantial claim
  • Findingown data

    The review included 33 randomized clinical trials with 2256 participants.

    “Thirty-three trials (2256 participants) were included.”
    • Also stated in: § Selection and Inclusion of Studies · plain
      “Consequently, 33 trials (2256 participants) met our inclusion criteria, and 28 of them had enough data for calculating effect sizes (eFigure 1 in the”
    Quote in the paperSubstantial claim
  • Findingown data

    In stand-alone designs at posttest, psychotherapy was more effective than control for suicide, with g = 0.44 (95% CI, 0.15-0.74).

    “suicide (g = 0.44; 95% CI, 0.15-0.74),”
    Quote in the paperSubstantial claim
  • May combine two claims. 26
  • Classified as probably not a substantial claim. 8

  • May combine two claims.

    Findingown data

    At follow-up, the combined borderline-relevant outcome had a significant medium effect in stand-alone trials but not in add-on trials.

    “Follow-up results for all borderline-relevant outcomes showed significant medium effects for stand-alone designs and nonsignificant results for add-on designs.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In add-on designs at posttest, effects were not significant for self-harm and parasuicidal behavior or for health service use.

    “Results were not significant for self-harm and parasuicidal behavior or for health service use, but the number of trials was small (range, 3-6).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    There were 2 deaths by suicide in treatment group and 5 in control group; each group had 6 all-cause deaths.

    “There were 2 deaths by suicide in the treatment group and 5 deaths by suicide in the control group.The treatment group and the control group each had 6 all-cause deaths.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    At follow-up, adjusting for missing studies (n=3) led to a nonsignificant g=0.19 (95% CI, -0.15 to 0.53), and Egger test was significant (intercept β=2.78; 95% CI, 0.18-5.39; P=.04).

    “At followup, considering all trials, adjustment for missing studies (n = 3) led to a nonsignificant Hedges g of 0.19 (95% CI, -0.15 to 0.53), and Egger test was significant (intercept β = 2.78; 95% CI, 0.18-5.39;P = .04).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Treatment dropout, duration, exposure in either arm, and the exposure difference between arms showed no significant relationship with outcomes.

    “Dropout rates in the treatment group, treatment duration, treatment exposure in the treatment group or the control group, and difference in treatment exposure between groups were not significantly related to outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In stand-alone designs at posttest, significant effects were found for all outcome categories, ranging from g=0.31 for borderline symptoms to g=0.44 for suicide.

    “Results showed significant effects for all outcome categories, ranging from 0.31 (0.04-0.57) for borderline symptoms to 0.44 (0.15-0.74) for suicide outcomes (Table 1).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In add-on designs at follow-up, psychotherapy had a nonsignificant effect g=0.35 (95% CI, -0.15 to 0.85) for all borderline-relevant outcomes, with high heterogeneity 79%.

    “Six trials had a nonsignificant effect (g = 0.35; 95% CI, -0.15 to 0.85) for all borderline-relevant outcomes (Table 1).Heterogeneity was high (79%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In stand-alone designs at follow-up, psychotherapy had a significant effect g=0.56 (95% CI, 0.17-0.95) for all borderline-relevant outcomes, with high heterogeneity 62%.

    “Seven trials had a significant effect of 0.56 (95% CI, 0.17-0.95)for all borderline-relevant outcomes (Table 1).Heterogeneity was high (62%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    At follow-up, across 13 trials, psychotherapy was more effective than control for borderline-relevant outcomes, with g = 0.45 (95% CI, 0.15-0.75).

    “Thirteen trials reported borderline-relevant outcomes at follow-up (g = 0.45; 95% CI, 0.15-0.75).”
    • Also stated in: § All Trials · plain
      “Combining both design types yielded a significant effect (g = 0.45; 95% CI, 0.15-0.75[13 trials]), with high heterogeneity (70%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Trials with an ad hoc control group, manualized control, study team involvement in control, or low risk of bias on 3 or 4 domains produced nonsignificant between-group effects.

    “Trials with an ad hoc control group developed as part of the study, trials in which the control intervention was manualized, or trials in which the study team was involved in treating the control group, as well trials with low RoB for 3 or 4 domains, generated nonsignificant between-group effects.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Because few trials contributed to some outcome categories, those results are tentative and may be spurious.

    “Nonetheless, the number of trials for some outcome categories was small, and these findings should be viewed as tentative and possibly spurious.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Interrater agreement was quantified, and disagreements were resolved through discussion.

    “Interrater agreement κ statistics were computed (eMethods in the Supplement), and disagreement was resolved by discussion among assessors and with the senior author (P.C.).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Follow-up heterogeneity was high and appeared to reflect variation in follow-up length and format, including naturalistic follow-ups and booster sessions.

    “Heterogeneity was high, reflecting substantial differences in follow-up duration and type among trials, with some being naturalistic and others including booster interventions, which in some cases were intensive.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The search covered four bibliographic databases and the reference lists of prior meta-analyses.

    “Studies were identified through searches in 4 bibliographical databases”
    • Also stated in: § Identification and Selection of Studies · plain
      “We also checked the reference lists of earlier meta-analyses.22,23”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A prior DBT meta-analysis found moderate effects on borderline-relevant outcomes, suicidality, and self-harm, but when limited to randomized trials the effects shrank and became nonsignificant for suicidality and self-harm.

    “One meta-analysis 22 of DBT for BPD reported moderate effects for borderline-relevant outcomes, suicidality, and self-harm.However, analysis restricted to randomized clinical trials (RCTs) showed reduced effects, with nonsignificance for suicidality and self-harm.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The Cochrane Collaboration's risk-of-bias instrument was applied across four domains.

    “Trial risk of bias (RoB) was evaluated within 4 domains of the Cochrane Collaboration Risk of Bias tool, 26 which assesses sources of bias in RCTs.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The Cochrane risk-of-bias domains and the summed overall score adequately capture bias in psychotherapy trials.

  • May combine two claims.

    Premisecitation

    Earlier meta-analyses on psychotherapy for BPD were few and applied narrow effectiveness criteria, without pooling different treatments.

    “Previous metaanalyses of psychotherapeutic treatments for BPD have been scarce and used focused criteria for assessing effectiveness, avoiding combining treatments.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [22]

      Not checked in the free run.

    • cites [23]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two independent raters carried out the risk-of-bias assessment and data extraction.

    “Risk of bias assessment and data extraction were performed by 2 independent assessors.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The authors checked for publication bias using funnel plots, trim-and-fill, and Egger's test.

    “We examined publication bias through visual funnel plot inspection, the trim-and-fill procedure 32 (which produces an effect size estimate after accounting for publication bias), and Egger test for funnel plot asymmetry.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Eligible randomized trials were chosen after full-text review by two separate assessors.

    “Two independent assessors (I.A.C. and C.D.C.) examined the full texts and selected eligible RCTs.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Because the two earlier meta-analyses stopped collecting studies before 2012, newer trials and follow-ups warranted inclusion.

    “Moreover, because the study collection dates of the 2 previous meta-analyses 22,23 preceded 2012, new trials or follow-ups of older trials published since then should be considered.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [22]

      Not checked in the free run.

    • cites [23]

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationown data

    This finding contradicts systematic claims from individual trials.

    “contradicting systematic claims from individual trials.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    A prior meta-analysis of treatment completion in BPD found high completion rates (about 75%) but substantial between-study heterogeneity.

    “One meta-analysis 60 of treatment completion in BPD reported high treatment completion rates (approximately 75%) but with substantial betweenstudy heterogeneity.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60]

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    A range of independent psychotherapies were effective for BPD-related symptoms, self-harm, suicide, health service use, and general psychopathology.

    “Various independent psychotherapies demonstrated efficacy for borderline-relevant symptoms, self-harm, suicide, health service use, and general psychopathology in BPD.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    The search was broad, but the authors may have missed trials that studied personality disorders generally and included some patients with BPD.

    “Our search was broad, but we may have missed trials that addressed personality disorders in general but ultimately had a sample composed of patients with BPD.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Because few trials were available, the authors grouped therapies into broader categories, which obscured finer differences between orientations.

    “Owing to the small number of trials, we grouped therapies in broader categories, effacing subtler differences between orientations.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    Adjunct medication was not standardized or consistently reported, and it could have confounded the psychotherapy effects.

    “The use of adjunct medication was neither standardized nor consistently reported and could have confounded psychotherapy effects.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    That prior meta-analysis included both observational and controlled trials, some randomized and some not.

    “However, included studies were both observational and controlled trials, randomized or not.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60]

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Most trials were not registered in clinical trial registries, so the authors could not assess risk of bias due to selective outcome reporting.

    “Furthermore, most trials had not been registered in clinical trial registries, so we could not rate RoB because of selective outcome reporting.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    That prior meta-analysis pooled absolute completion rates for the experimental group, a method discouraged because it can produce very high heterogeneity.

    “Instead, they pooled absolute rates for the former, a procedure that is discouraged because it can lead to extremely high levels of heterogeneity.61”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [60]

      Not checked in the free run.

    • cites [61]

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Approaches that are often cited, including schema-focused therapy, were underrepresented, mainly because they were mostly studied in head-to-head trials.

    “Frequently cited approaches, such as schema-focused therapy, were underrepresented, mainly because they were mostly studied in head-to-head trials.”
    Quote in the paperNot a substantial claim
31 of 31

  • The paper relies on this without support.

    Most trials that showed effectiveness had the treatment developer directly involved.

    “However, most trials demonstrating effectiveness were conducted with the direct participation of the treatment developer.”

  • The authors state this as an assumption.

    Grouping different psychotherapies into broad categories yields meaningful and comparable efficacy estimates.

    “Conversely, because effectiveness differences between therapies appear to be limited and because variations of the same intervention are to be expected in diverse implementation settings, we believe that a broader effectiveness evaluation grouping therapies into theoretically intelligible categories is germane.”

  • The paper relies on this without support.

    The control conditions across included trials are sufficiently comparable to be pooled as a single control category.

    “No constraints were placed on the control group, which could include (but was not restricted to) TAU or other treatments not specifically developed for BPD.”

  • The paper relies on this without support.

    The Cochrane risk-of-bias domains and the summed overall score adequately capture bias in psychotherapy trials.

    “Trial risk of bias (RoB) was evaluated within 4 domains of the Cochrane Collaboration Risk of Bias tool, 26 which assesses sources of bias in RCTs.”

  • The paper relies on this without support.

    Treatment retention is a valid indicator of treatment acceptability or effectiveness.

    “Treatment retention was computed as the comparative dropout rates between the intervention and control groups.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The efficacy of DBT-A for treating BPD symptoms among adolescents who self-injure remains to be evaluated.

    “the efficacy of DBT-A for treating BPD symptoms among adolescents who self-injure remains to be evaluated (Cristea et al., 2017).”

    From Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis (2021) · cites this paper as Cristea et al., 2017

    The Identification and Selection of Studies section (page unavailable) says the review excluded even partially adolescent samples because BPD diagnosis and treatment pose distinct challenges for that group. This means the review cannot establish DBT-A’s efficacy for adolescents who self-injure, but it does not specifically assess DBT-A or establish that its efficacy had not been evaluated elsewhere. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • DBT has shown success in treating BPD symptoms in adults.

    “although DBT has shown success in treating BPD symptoms in adults”

    From Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis (2021) · cites this paper as Cristea et al., 2017

  • Over the past twenty years, treatment studies have shown that a diverse range of manualized treatments for BPD such as dialectical behaviour therapy, transference-focused psychotherapy, mentalization based therapy, or schema therapy are effective with medium to large effect sizes and remission achievable in a high percentage of cases.

    “Over the past twenty years, treatment studies have flourished showing that a diverse range of manualized treatments for BPD such as dialectical behaviour therapy (DBT), transference-focused psychotherapy (TFP), mentalization based therapy (MBT), or schema therapy are effective with medium to large effect sizes and remission achievable in a high percentage of cases [28, 29].”

    From Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges (2020) · cites this paper as [28]

  • Today, a range of effective psychotherapeutic interventions are available for people with personality disorders in most of the countries that have so far legalized EAS.

    “Today, a range of effective psychotherapeutic interventions are available for people with personality disorders in most of the countries that have so far legalized EAS.”

    From Euthanasia and assisted suicide in patients with personality disorders: a review of current practice and challenges (2020) · cites this paper as [28]

  • A recent meta-analysis concluded that both DBT and psychodynamic approaches are effective for BPD symptoms.

    “in a recent meta-analysis it was concluded that both DBT and psychodynamic approaches (the last category defined very broadly and including both MBT and brief therapy based on psychoanalytic principles) are effective for BPD symptoms [25].”

    From European guidelines for personality disorders: past, present and future (2019) · cites this paper as [25]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Follow-up heterogeneity is called high below the paper's stated threshold

    Minor

    The methods identify 75% as the threshold for high heterogeneity, but the results describe follow-up heterogeneity of 70% as high. The stand-alone follow-up result is likewise called high at 62%.

1 of 1

Cites

Flagged first, then by citations

2 of the 72 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Hedges LV, Olkin I. Statistical Methods for Meta-Analysis. Orlando, FL: Academic Press; 1985.

Cited by

Sorted by citations

Related

Authors
Cristea, I. A., Gentili, C., Cotet, C. D., Palomba, D., Barbui, C., & Cuijpers, P.
Affiliations
  • University of Padua (IT)
  • Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
  • University of Verona (IT)
  • Amsterdam Public Health (NL)
Corresponding author
Cristea, Ioana A.
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2017-04-01
Volume
74
Issue
4
Pages
319
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2016.4287
OpenAlex
W2592963919
Semantic Scholar
464a03e120510e87d9085d8a94d7e412e2f34bbd
Cited by
655
References
72
Citations by year
2026: 48 · 2025: 57 · 2024: 64 · 2023: 60 · 2022: 76 · 2021: 86 · 2020: 102 · 2019: 80 · 2018: 59 · 2017: 22 · 2016: 1
FWCI
10.99
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Padua Research Archive (University of Padova) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders
  • National Authority for Scientific Research and Innovation
  • Università degli Studi di Padova
  • Autoritatea Natională pentru Cercetare Stiintifică
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
borderline personality disorder, psychotherapy efficacy, dialectical behavior therapy, transference-focused psychotherapy, self-harm, suicide, borderline symptoms, treatment retention, health care utilization, general psychopathology, risk of bias, subgroup analysis, meta-regression, risk of bias in meta-analysis
MeSH terms
Suicide Prevention, Behavior Therapy, Borderline Personality Disorder, Humans, Psychotherapy, Suicide, Randomized Controlled Trials as Topic, Self-Injurious Behavior, Treatment Outcome, Psychotherapy, Psychodynamic

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