8-Year Follow-Up of Patients Treated for Borderline Personality Disorder: Mentalization-Based Treatment Versus Treatment as Usual

Abstract

Objective: This study evaluated the effect of mentalization-based treatment by partial hospitalization compared to treatment as usual for borderline personality disorder 8 years after entry into a randomized, controlled trial and 5 years after all mentalization-based treatment was complete. Method: Interviewing was by research psychologists blind to original group allocation and structured review of medical notes of 41 patients from the original trial. Multivariate analysis of variance, chi-square, univariate analysis of variance, and nonparametric Mann-Whitney statistics were used to contrast the two groups depending on the distribution of the data. Results: Five years after discharge from mentalization-based treatment, the mentalization-based treatment by partial hospitalization group continued to show clinical and statistical superiority to treatment as usual on suicidality (23% versus 74%), diagnostic status (13% versus 87%), service use (2 years versus 3.5 years of psychiatric outpatient treatment), use of medication (0.02 versus 1.90 years taking three or more medications), global function above 60 (45% versus 10%), and vocational status (employed or in education 3.2 years versus 1.2 years). Conclusions: Patients with 18 months of mentalization-based treatment by partial hospitalization followed by 18 months of maintenance mentalizing group therapy remain better than those receiving treatment as usual, but their general social function remains impaired.

A two-model integrated personality disorder service: effect on bed use

“…4 Partial hospitalisation over a 5-day week with a mentalisationbased treatment (MBT) approach to care has been shown to decrease this burden, reducing the duration of in-patient care among patients with borderline personality disorder, 5 in addition to a reduction in rates of self-harm and suicidality. 6,7 The provision of inexpensive open-access service user network (SUN) groups has also demonstrated effectiveness in reducing emergency department attendance among patients with personality disorder. 8 A working party survey of the London Borough of Croydon previously highlighted the need for service development geared towards intervention for people with personality disorder, with an estimated 4000 people having a diagnosis of personality disorder 9 but with no access to a specialist intervention.…”

Autistic and schizotypal traits and global functioning in bipolar I disorder

“…While global functioning is not a test of mentalising per se, it has been shown to be associated with socio-cognitive abilities (Bo, Kongerslev, Dimaggio, Lysaker, & Abu-Akel, 2015) and improve following mentalising-based treatments (Bateman & Fonagy, 2008). Todate, no study has investigated the effect of co-occurring autistic and schizotypal traits on an outcome of clinical value in a psychiatric population.…”

Eficacia de la psicoterapia para el tratamiento del Trastorno Límite de la Personalidad: Una revisión

“…Bateman & Fonagy, 2008;Bateman & Fonagy 2009) en ansiedad, depresión, psicopatología general, sínto-mas límites y funcionamiento global e interpersonal además de una disminución de las conductas autolíticas y autolesivas. Finalmente, la Terapia Conversacional de Hobson (TCH) supuso una mejoría significativa de la sintomatología TLP y del funcionamiento global.…”