A preliminary study of the naturalistic course of non-manualized psychotherapy for outpatients with borderline personality disorder: Patient characteristics, attrition and outcome

Abstract

Background: Psychotherapy is an effective treatment for borderline personality disorder (BPD), but little is known about the long-term effect of non-manualized psychotherapy for these patients. Aims: The aim of the preliminary study was to investigate the long-term effect of non-manualized psychotherapy on an outpatient sample (n = 32) with a primary diagnosis of BPD. Methods: The current study was based on an open-ended naturalistic design with a 2-year follow-up. Assessment at intake, discharge and follow-up comprised the Structured Clinical Interview for DSM-IV Axis I, II and V, and the general level of self-reported symptomatic (SCL-90R) and interpersonal distress (IIP-64C). Results: Patients with BPD respond well to non-manualized psychotherapy as intent-to-treat analyses estimate that 62% no longer met the DSM-IV criteria for a BPD diagnosis at discharge, 66% at 2-year follow-up. In addition, significant improvement with large effect sizes was found for all outcome variables at both discharge and at follow-up. Attrition was associated with patient–therapist gender mismatch, low occupational status and the presence of post-traumatic stress disorder. Conclusion: The results imply that the natural course of non-manualized psychotherapy is overall beneficial for outpatients with BPD.

• Attrition
• Borderline personality disorder
• Outcome

Acknowledgements

This study has used data from the Norwegian Multisite Study of Process and Outcome in Psychotherapy (NMSPOP) that was supported by grants from Medicine and Health, the Norwegian Research Council; Health and Rehabilitation through the Norwegian Council of Mental Health; Department of Psychology, University of Oslo; and the Faculty of Psychology, University of Bergen.

Declaration of interest: None.