Adapting interpersonal psychotherapy for borderline personality disorder

Abstract

Background: Among the important characteristics of borderline personality disorder (BPD) are interpersonal difficulties and depressive symptoms. Interpersonal psychotherapy (IPT), one of the best tested time-limited psychotherapies for certain DSM-IV Axis I disorders, has demonstrated efficacy in improving psychosocial functioning and in treating major depressive disorder.

Aims: This paper describes the rationale for testing IPT as a treatment for patients with BPD, the adaptation of standard IPT for such patients, and the commencement of an open, pilot study of initial tolerance and feasibility.

Method: The authors developed a treatment manual adapting IPT to BPD. Changes from standard IPT included: (i) conceptualization, and (ii) chronicity of the disorder, (iii) difficulties in forming and maintaining the treatment alliance, (iv) length of treatment, (v) suicide risk, (vi) termination, and (vii) choice of subjects within the BPD spectrum of diagnosis.

Results: The manual is being tested in an open, eight-month trial. Early results of the intervention are discussed.

Conclusions: IPT may provide an alternative to existing treatments for patients with BPD who have interpersonal difficulties.

Declaration of interest: This work was supported by a grant from the National Alliance for Research on Schizophrenia and Depression (NARSAD). The lead author has published books on IPT with American Psychiatric Press, Basic Books, Franco Angeli, and Editions Médecine & Hygiène Société.

Keywords:

• Borderline personality disorder
• interpersonal psychotherapy