Effectiveness of psychotherapeutic treatment of personality disorder.
BACKGROUND
Psychiatrists have been criticised for failing to develop adequate treatment for personality disorder. Psychotherapeutic treatments are promising, but their effectiveness is uncertain.


OBJECTIVE
To investigate the evidence for effectiveness of psychotherapeutic treatment for personality disorder.


METHODS
Systematic literature review.


RESULTS
There is evidence for the effectiveness of psychotherapy for personality disorder. Problems of case identification, comorbidity, randomisation, specificity of treatment and outcome measurement are inadequately addressed. Authors mainly relied on cohort studies. Evidence neither suggests superiority of one type of therapy over another nor indicates which subgroups of patients should be offered psychotherapy as in-patient, day patient, or out-patient.


CONCLUSIONS
New research strategies are needed to show that personality change is both measurable and clinically meaningful. Effectiveness studies using randomised controlled designs are required. The literature suggests that effective treatment should be long-term, integrated, theoretically coherent and focused on compliance.
Bateman
A W
AW
Halliwick Psychotherapy Unit, St Ann's Hospital, London.
Fonagy
P
P
D015331:Cohort Studies; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010554:Personality Disorders / Q000628:therapy*; D011613:Psychotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome