A systematic review of dialectical behavioural therapy compared with mentalization-based therapy for the treatment of Borderline Personality Disorder

Borderline personality disorder (BPD) is a complex disorder, which places an extensive burden on health services. BPD is considered challenging to treat, which increases the need for large evidence-bases for interventions. However, the evidence-base for psychological interventions has been historically neglected in the research literature.

I conducted a systematic review of two psychological treatments for BPD; Dialectical Behavioural therapy (DBT) and Mentalization-Based therapy (MBT), comparing their effectiveness. Twelve studies (2 MBT and 10 DBT) were included in this systematic review. A meta-analysis demonstrated that both therapies effectively reduce self harm. There appear to be therapeutic benefits for BPD patients treated with MBT and DBT compared to a control condition, but improvements have been inconsistent: many outcomes appear to be more beneficial in MBT and DBT compared to TAU, but no different compared to other manualised treatments which include effects such as attention to patients. Unfortunately when this review was performed before there were enough existing randomised controlled trials to fully explore the effects of psychological therapy for borderline personality disorder.