The efficacy of schema therapy for personality disorders: a systematic review and meta-analysis

Abstract

Objective

Personality disorders (PDs) are prevalent and associated with functional impairment and psychological disability. Studies suggest that schema therapy (ST) may be an effective treatment for PDs. This review aimed to evaluate the efficacy of ST in treating PDs.

Method

We conducted a comprehensive literature search using PubMed, Embase, Web of Science, CENTRAL, PsycInfo, and Ovid Medline. We identified eight randomized controlled trials (587 participants) and seven single-group trials (163 participants).

Results

Meta-analyses revealed that ST had a moderate effect size (g = 0.359) compared to control conditions in reducing symptoms of PDs. Subgroup analysis indicated that the effect of ST on different types of PDs varied slightly, and that group ST (g = 0.859) was more effective than individual ST (g = 0.163) in treating PDs. Secondary outcome analysis revealed a moderate effect size (g = 0.256) for ST compared to control conditions in improving quality of life, and ST was found to reduce early maladaptive schema (g = 0.590). Single-group trials analysis showed that ST had a positive effect on PDs (OR = 0.241).

Conclusion

ST appears to be an effective treatment for PDs, as it reduces symptoms and improves quality of life. This review provides support for the use of ST in the treatment of PDs.

Keywords:

• Personality disorders
• schema therapy
• meta-analysis
• systematic review

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Anhui Natural Science Foundation (1808085MH291), and Key Laboratory of Philosophy and Social Science of Anhui Province on Adolescent Mental Health and Crisis Intelligence Intervention (SYS2023B08).

Notes on contributors

Kaiyuan Zhang

Kaiyuan Zhang, Master of Medicine, Psychiatrist, specializing in the treatment of depression and anxiety disorders.

Xinyang Hu

Xinyang Hu Master of Medicine, the primary area of research is the analysis of factors influencing psychological disorders and the causes in clinical patients.

Lijun Ma

Lijun Ma Master of Education, with the main research area being clinical interventions for psychological disorders and their neural mechanisms.

Qihang Xie

Qihang Xie, Master of Medicine, Clinical Medicine Major, proficient in Meta-Analysis techniques.

Zhipeng Wang

Zhipeng Wang, Master of Medicine, the primary area of research is the analysis of the causes and intervention mechanisms of psychosomatic diseases.

Chuan Fan

Chuan Fan, Master of Medicine, Doctor of Science, main practitioner in psychology, proficient in psychotherapy for common mental disorders.

Xiaoming Li

Xiaoming Li, Professor, received his Ph.D. from School of Life Sciences, University of Science and Technology of China, and research interests focused on various aspects of medical psychology, psychiatry.