Cognitive therapy versus Rogerian supportive therapy in borderline personality disorder. Two-year follow-up of a controlled pilot study.
BACKGROUND
To date, there have been no studies comparing cognitive therapy (CT) with Rogerian supportive therapy (RST) in borderline personality disorder.


METHODS
Sixty-five DSM-IV borderline personality disorder outpatients were recruited at 2 centres: Lyon and Marseille. Thirty-three patients were randomly allocated to CT and 32 to RST. The therapists were the same in both groups. Both treatments shared the same duration (1 year) and amount of therapy. Assessment by independent evaluators utilised the Clinical Global Impression (CGI) Scale, the Hamilton Depression Scale, Beck Depression Inventory, Beck Anxiety Inventory, Hopelessness Scale, Young Schema Questionnaire II, Eysenck Impulsivity Venturesomeness Empathy (IVE) Inventory, a self-harming behaviours checklist and scales measuring quality of life and the therapeutic relationship. The response criterion was a score of 3 or less on the CGI, associated with a Hopelessness Scale score of <8.


RESULTS
No patient committed suicide during the trial. Fifty-one patients were evaluated at week 24, 38 at week 52 and 21 at week 104. Cognitive therapy retained the patients in therapy for a longer time. The response criterion found no significant between-group differences at any measurement point in the completers. However, at week 24, CT was better than RST on the Hopelessness Scale, IVE scale and regarding the therapeutic relationship. At week 104, the CGI improvement (patient and evaluator) was significantly better in CT than in RST. High baseline depression and impulsivity predicted dropouts.


CONCLUSIONS
CT retained the patients in therapy longer, showed earlier positive effects on hopelessness and impulsivity, and demonstrated better long-term outcomes on global measures of improvement.
Cottraux
Jean
J
Hospices Civils de Lyon, Hôpital Neurologique, Lyon, France. cottraux@univ-lyon1.fr
Note
Ivan Druon
ID
Boutitie
Florent
F
Milliery
Maud
M
Genouihlac
Virginie
V
Yao
Sai Nan
SN
Note
Brigitte
B
Mollard
Evelyne
E
Bonasse
Françoise
F
Gaillard
Ségolène
S
Djamoussian
Diane
D
Guillard
Chantal de Mey
Cde M
Culem
Alain
A
Gueyffier
François
F
D000328:Adult; D001883:Borderline Personality Disorder / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007175:Impulsive Behavior / Q000150:complications / Q000523:psychology / Q000628:therapy; D008297:Male; D009629:Person-Centered Psychotherapy / Q000379:methods*; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome; D000092864:Suicide Prevention