Dropout rates from psychotherapy trials for borderline personality disorder: A meta-analysis.

Iliakis, Evan Alexander; Ilagan, Gabrielle Silva; Choi-Kain, Lois Wonsun

doi:10.1037/per0000453

Cited by 83Personality Disorders and PsychopathologyPsychotherapy Techniques and ApplicationsBipolar Disorder and Treatment

Dropout rates from psychotherapy trials for borderline personality disorder: A meta-analysis.

Iliakis, Evan Alexander, Ilagan, Gabrielle Silva, Choi-Kain, Lois Wonsun·2021·Personality Disorders: Theory, Research, and Treatment

DOI 10.1037/per0000453

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Abstract

Borderline personality disorder (BPD) is a serious mental illness associated with heightened disability, risk for suicide, and costs to society. This study aims to meta-analytically quantify dropout rates from psychotherapies of BPD, identify moderators, and assess reasons for dropout and time taken to dropout. PubMed, PsycINFO, and MEDLINE were screened from database inception to March 2020 for trials that investigated psychotherapies for individuals with BPD reporting dropout rates. The primary outcomes were pooled dropout rates and differential treatment retention across all studies, all randomized controlled trials (RCT), all outpatient studies, and all outpatient RCTs. Random effects meta-analysis, metaregression analyses, and publication bias tests were conducted. Information on reasons for dropout and time to dropout was synthesized qualitatively. Dropout rates were 22.3% considering all studies, and 28.2% when only considering outpatient randomized controlled trials. Odds of dropout were not significantly higher in the control condition than in the intervention condition. Longer duration, randomization, phone coaching, and outpatient setting were associated with higher dropout rates, but only when considering all studies. Publication bias-adjusted dropout rates were as high as 29.9%. Reasons for dropout included dissatisfaction with treatment, expulsion from treatment, and lack of motivation. Most dropouts occurred in the first half of treatment. Dropout is an important and prevalent issue in BPD psychotherapies. Reported rates are minimized by publication bias, and moderators of dropout rates are inconsistent. Subsequent research should identify obstacles to completing treatment and investigate ways to organize treatment allocation to enhance treatment retention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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A recent meta-analysis of treatment dropout across therapy for people with a diagnosis of BPD ranged between 22 and 30%.
“A recent meta-analysis of treatment dropout across therapy for people with a diagnosis of BPD ranged between 22 and 30%. 13”
From Acceptability and feasibility of a short-term group therapy for people with borderline personality disorder symptoms (2024) · cites this paper as [13]

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Authors: Iliakis, E. A., Ilagan, G. S., & Choi-Kain, L. W.
Affiliations: McLean Hospital (US)
ORCID: Iliakis, Evan Alexander
Ilagan, Gabrielle Silva
Choi-Kain, Lois Wonsun
Venue: Personality Disorders: Theory, Research, and Treatment
Publisher: American Psychological Association (APA)
Published: 2021-05
Volume: 12
Issue: 3
Pages: 193-206
ISSN: 1949-2715 (ISSN-L)
1949-2723
DOI: 10.1037/per0000453
OpenAlex: W3129983697
Cited by: 83
References: 0
Citations by year: 2026: 22 · 2025: 23 · 2024: 17 · 2023: 7 · 2022: 13 · 2021: 1
FWCI: 6.48
Type: journal article
Language: en
Open access: closed
Locations: Personality Disorders Theory Research and Treatment (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords: borderline personality disorder, psychotherapy dropout, treatment retention, outpatient psychotherapy, randomized controlled trials, publication bias, causes of dropout, treatment duration, phone coaching
MeSH terms: Borderline Personality Disorder, Humans, Motivation, Psychotherapy, Suicide

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Dropout rates from psychotherapy trials for borderline personality disorder: A meta-analysis.

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