Five-year outcome of outpatient psychotherapy with borderline patients.
BACKGROUND
Borderline personality disorder (BPD) is a serious mental illness. Due to scepticism about the effectiveness of its treatment, the care of these patients is neglected. In this study we evaluated the effect of treatment 5 years after its ending, of patients with BPD.


METHODS
Thirty subjects were treated twice weekly for 1 year by psychotherapy based on the 'Conversational Model' of Hobson. Outcome measures included time in hospital, number of episodes of violence and self-harm, number of medical appointments, drug use and work history. A 'morbidity budget' made up of these items was collated for the year before treatment, the year following treatment, and for the year preceding the 5-year follow-up. Additional measures included DSM-III criteria and a self-report of symptoms. These outcomes were compared to a hypothetical natural history of BPD constructed from the DSM scores of 150 borderline patients aged between 18 and 52 years.


RESULTS
Except for one measure, the improvements evident 1 year following treatment were maintained 4 years later. This improvement was not predicted by the hypothetical natural history.


CONCLUSIONS
A particular form of treatment of BPD has relatively long-lasting, beneficial effects.
Stevenson
Janine
J
Department of Psychological Medicine, The University of Sydney, Westmead Hospital, Westmead, Australia. jstevens@mail.usyd.edu.au
Meares
Russell
R
D'Angelo
Roberto
R
D000328:Adult; D000553:Ambulatory Care; D001883:Borderline Personality Disorder / Q000534:rehabilitation / Q000628:therapy*; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D011613:Psychotherapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome