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Combined Dialectical Behavior Therapy and Fluoxetine in the Treatment of Borderline Personality Disorder
Abstract
BACKGROUND: This study examines the therapeutic effect of fluoxetine, a selective serotonin reuptake inhibitor, added to dialectical behavior therapy (DBT), an empirically supported psychosocial therapy, for the treatment of borderline personality disorder. METHOD: This is a 12-week, randomized, double-blind, placebo-controlled study of patients with borderline personality disorder (identified using the Structured Clinical Interview for DSM-IV Axis II Disorders). All subjects received individual and group DBT. Of the 20 subjects that completed treatment, 9 were randomly assigned to receive up to 40 mg/day of fluoxetine and 11 were randomly assigned to the placebo condition. Subjects were evaluated at baseline and at week 10 or 11 on self-report measures of depression, anxiety, anger expression, dissociation, and global functioning. The study was conducted between January 1998 and February 2000. RESULTS: Time-by-group interaction effects revealed no significant group differences in scores from pre-treatment to posttreatment on any measure. However, within the DBT/placebo group, there were significant pretreatment/posttreatment differences in the direction of improvement on all measures. No significant pre-treatment/posttreatment differences were found within the DBT/fluoxetine condition. CONCLUSION: The data suggest that adding fluoxetine to an efficacious psychosocial treatment does not provide any additional benefits. Further studies with larger sample sizes are warranted.
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“the pharmacotherapy review (Stoffers 2010) included three trials testing psychotherapy plus drug against psychotherapy plus placebo (Simpson 2004;Soler 2005;Linehan 2008).”
From Psychological therapies for people with borderline personality disorder. (2012) · cites this paper as Simpson 2004
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Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C., van Asselt, T., Kremers, I., Nadort, M., & Arntz, A. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.6.649 · Cited by 1,248
Psychological therapies for people with borderline personality disorder.
Stoffers-Winterling, J. M., Völlm, B. A., Rücker, G., Timmer, A., Huband, N., & Lieb, K. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005652.pub2 · Cited by 895
Borderline personality disorder
Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011) · The Lancet · doi:10.1016/s0140-6736(10)61422-5 · Cited by 895
Efficacy of the third wave of behavioral therapies: A systematic review and meta- analysis
Öst, L.-G. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.12.005 · Cited by 727
Kliem, S., Kröger, C., & Kosfelder, J. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0021015 · Cited by 474
Metadata
- Authors
- Simpson, E. B., Yen, S., Costello, E., Rosen, K., Begin, A., Pistorello, J., & Pearlstein, T.
- Affiliations
- Harvard University (US)
- Brown University (US)
- University of Nevada, Reno (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2004-03-15
- Volume
- 65
- Issue
- 3
- Pages
- 379-385
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2025624676
- Cited by
- 156
- References
- 0
- Citations by year
- 2026: 5 · 2024: 7 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 9 · 2016: 3 · 2015: 3 · 2014: 11 · 2013: 12 · 2012: 10
- FWCI
- 11.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- borderline personality disorder, dialectical behavior therapy, fluoxetine, selective serotonin reuptake inhibitors, psychosocial interventions, depression, anxiety, anger expression, dissociation, global functioning
- MeSH terms
- Adult, Behavior Therapy, Borderline Personality Disorder, Combined Modality Therapy, Double-Blind Method, Female, Fluoxetine, Humans, Surveys and Questionnaires, Selective Serotonin Reuptake Inhibitors, Diagnostic and Statistical Manual of Mental Disorders
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