Recovery from Borderline Personality Disorder: A Systematic Review of the Perspectives of Consumers, Clinicians, Family and Carers

Abstract

PurposeLongitudinal studies support that symptomatic remission from Borderline Personality Disorder (BPD) is common, but recovery from the disorder probably involves a broader set of changes in psychosocial function over and above symptom relief. A systematic review of literature on both symptomatic and personal recovery from BPD was conducted including the views of consumers, clinicians, family and carers.Materials and MethodsA PRISMA guided systematic search identified research examining the process of recovery from BPD. Longitudinal studies with a follow-up period of five or more years were included to avoid treatment effects.ResultsThere were 19 studies, representing 11 unique cohorts (1,122 consumers) meeting the review criteria. There was a limited focus on personal recovery and the views of family and carers were absent from the literature. Rates of remission and recovery differ depending upon individual and methodological differences between studies. Data on symptomatic remission, recurrence and diagnosis retainment suggests that BPD is a stable condition, where symptomatic remission is possible and the likelihood of recurrence following a period of remission is low.ConclusionSymptomatic remission from BPD is common. However, recovery including capacities such as engaging in meaningful work was seldom described. Future research needs broader measures of recovery as a sub-syndromal experience, monitoring consumer engagement in meaningful vocation and relationships, with or without the limitations of BPD.

A 1‐year follow‐up study of capacity to love and work: What components of borderline personality disorder most impair interpersonal and vocational functioning?

“…This further supports the understanding that good psychosocial function is more difficult to achieve and sustain than symptomatic remission. There is a need to study psychosocial functioning more broadly, and expanding this area of research is also strongly supported by people with lived experience . Indeed, economic evaluations point to the benefits of treatment not only in terms of financial benefits for the patient and savings to the health system but also society gains from greater productivity and paying taxes .…”

“…There is a need to study psychosocial functioning more broadly, and expanding this area of research is also strongly supported by people with lived experience. 14,15 Indeed, economic evaluations point to the benefits of treatment not only in terms of financial benefits for the patient and savings to the health system but also society gains from greater productivity and paying taxes. 16 In order to further develop treatments targeting function, a comprehensive understanding of what factors may contribute to persistent psychosocial impairment is required.…”

Staff perceptions of borderline personality disorder and recovery: A Q‐sort method approach

“…Little research has been conducted to explore perspectives of recovery in borderline personality disorder. A recent systematic review by Ng, Bourke, and Grenyer () aimed to understand how patients, clinicians, family, and carers perceived recovery from borderline personality disorder. The review identified 16 longitudinal quantitative studies with 11 unique cohorts, and three qualitative studies (Larivière et al., ; Katsakou et al., ; Holm & Severinsson, ) that examined recovery in borderline personality disorder.…”

“…Overall, Ng et al. () found a greater emphasis on symptomatic remission as an indicator of recovery compared to other mental health problems. Despite the aims of the review, Ng et al.…”

“…Despite the aims of the review, Ng et al. () was unable to identify any articles that explored the perspectives of clinicians, family, or carers. This highlights the necessity for researchers to examine the perspectives of these groups, as they all play an integral role in the recovery of patients with borderline personality disorder.…”