Mentalization‐based treatment in groups for adolescents with borderline personality disorder: a randomized controlled trial
Open accessAbstract
Background: Borderline personality disorder (BPD) typically onsets in adolescence and predicts later functional disability in adulthood. Highly structured evidence‐based psychotherapeutic programs, including mentalization‐based treatment (MBT), are first choice treatment. The efficacy of MBT for BPD has mainly been tested with adults, and no RCT has examined the effectiveness of MBT in groups (MBT‐G) for adolescent BPD. Method: A total of 112 adolescents (111 females) with BPD (106) or BPD symptoms ≥4 DSM‐5 criteria (5) referred to child and adolescent psychiatric outpatient clinics were randomized to a 1‐year MBT‐G, consisting of three introductory, psychoeducative sessions, 37 weekly group sessions, five individual case formulation sessions, and six group sessions for caregivers, or treatment as usual (TAU) with at least 12 monthly individual sessions. The primary outcome was the score on the borderline personality features scale for children (BPFS‐C); secondary outcomes included self‐harm, depression, externalizing and internalizing symptoms (all self‐report), caregiver reports, social functioning, and borderline symptoms rated by blinded clinicians. Outcome assessments were made at baseline, after 10, 20, and 30 weeks, and at end of treatment (EOT). The ClinicalTrials.gov identifier is NCT02068326. Results: At EOT, the primary outcome was 71.3 ( SD = 15.0) in the MBT‐G group and 71.3 ( SD = 15.2) in the TAU group (adjusted mean difference 0.4 BPFS‐C units in favor of MBT‐G, 95% confidence interval −6.3 to 7.1, p = .91). No significant group differences were found in the secondary outcomes. 29% in both groups remitted. 29% of the MBT group completed less than half of the sessions compared with 7% of the control group. Conclusions: There is no indication for superiority of either therapy method. The low remission rate points to the importance of continued research into early intervention. Specifically, retention problems need to be addressed.
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Dropout rates varied widely, ranging from 15 to 75%.
“Dropout rates varied widely, ranging from 15 to 75%.”
From The (cost-)effectiveness of early intervention (MBT-early) versus standard protocolized treatment (CBT) for emerging borderline personality disorder in adolescents (the EARLY study): a study protocol for a randomized controlled trial (2024) · cites this paper as [22]
The Treatment completion section reports different premature-termination rates in the two trial arms: 25% in usual care and 56% in group MBT, calculated from the stated completion rates. It supports variation in dropout, but does not report a range of 15% to 75% (searched for that range and related dropout terms). (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe evidence base for these adaptations is rather scarce; a recent review identified only ten randomized clinical trials.
“The evidence base for these adaptations is rather scarce. A recent review identified only ten randomized clinical trials [22–31].”
The majority of these trials did not show the superiority of the specialized treatments compared with treatment as usual.
“The results indicate that the majority of these trials did not show the superiority of the specialized treatments compared with treatment as usual.”
The heterogeneity of the samples involved in these studies is typically large.
“Moreover, the heterogeneity of the samples involved in these studies is typically large [17, 22].”
From The (cost-)effectiveness of early intervention (MBT-early) versus standard protocolized treatment (CBT) for emerging borderline personality disorder in adolescents (the EARLY study): a study protocol for a randomized controlled trial (2024) · cites this paper as [22]
The Participants section describes eligibility for this single trial, and the limitations discussion says it had few exclusion criteria and high external validity. Neither passage assesses whether samples across the studies cited in the claiming sentence are typically highly heterogeneous; searches for “heterogeneity” and heterogeneous samples found no such assessment in our copy. No page numbers were available for these passages. (LLM, conf=0.74)
Experimental — accuracy not yet measured
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“A recent review identified only ten randomized clinical trials [22–31].”
Background
- Authors
- Beck, E., Bo, S., Jørgensen, M. S., Gondan, M., Poulsen, S., Storebø, O. J., Fjellerad Andersen, C., Folmo, E., Sharp, C., Pedersen, J., & Simonsen, E.
- Affiliations
- University of Copenhagen (DK)
- Region Zealand (DK)
- University of Southern Denmark (DK)
- Child and Adolescent Psychiatric Department Region Zealand Denmark
- Oslo University Hospital (NO)
- University of the Free State (ZA)
- Corresponding author
- Beck, Emma
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2019-11-08
- Volume
- 61
- Issue
- 5
- Pages
- 594-604
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- OpenAlex
- W2986237036
- Cited by
- 93
- References
- 58
- Citations by year
- 2026: 16 · 2025: 14 · 2024: 13 · 2023: 11 · 2022: 7 · 2021: 17 · 2020: 15
- FWCI
- 11.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (acceptedVersion, other-oa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, other-oa)
- Funders
- TrygFonden (115638)
- 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, adolescents, mentalization-based treatment, group therapy, treatment retention, early intervention, self-harm, depression, caregiver involvement, case formulation
- MeSH terms
- Mentalization, Adolescent, Adult, Borderline Personality Disorder, Depression, Female, Humans, Internal-External Control, Male, Self-Injurious Behavior, Treatment Outcome
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