Psychotherapies for Adolescents with Subclinical and Borderline Personality Disorder: A Systematic Review and Meta-Analysis
Open accessAbstract
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.
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A more recent meta-analysis found no effect on suicide attempts in treatments of BPD for adolescents from pre to post treatment, including DBT-A.
“A more recent meta-analysis found no effect on suicide attempts in treatments of BPD for adolescents from pre to post treatment, including DBT-A [42].”
From Evaluation of dialectical behavior therapy for adolescents in routine clinical practice: a pre-post study (2024) · cites this paper as [42]
The ‘Suicide Attempts and Nonsuicidal Self-Injury’ section reports no significant difference in suicide-attempt frequency between psychotherapy and control arms at treatment completion (OR 1.03, 95% CI 0.46–2.30); the reviewed trials included DBT-A. This supports the between-group finding, but not the claim that suicide attempts showed no change from pre- to posttreatment within the treatment groups. (LLM, conf=0.87)
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- Authors
- Wong, J., Bahji, A., & Khalid-Khan, S.
- Affiliations
- Queen's University (CA)
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
- Corresponding author
- Bahji, Anees
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2019-09-26
- Volume
- 65
- Issue
- 1
- Pages
- 5-15
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- PMC
- PMC6966252
- OpenAlex
- W2975570786
- Cited by
- 76
- References
- 29
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 12 · 2023: 17 · 2022: 10 · 2021: 16 · 2020: 6
- FWCI
- 1.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed Central (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, adolescents, psychotherapy, non-suicidal self-injury, suicide attempts, treatment retention, functional recovery, treatment efficacy, follow-up outcomes
- MeSH terms
- Adolescent, Borderline Personality Disorder, Humans, Psychotherapy, Psychotropic Drugs, Self-Injurious Behavior
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