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


OBJECTIVE
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.


CONCLUSIONS
The results imply that the natural course of non-manualized psychotherapy is overall beneficial for outpatients with BPD.
Nysaeter
Tor E
TE
Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway. Tor.Nysater@svt.ntnu.no
Nordahl
Hans M
HM
Havik
Odd E
OE
D000328:Adult; D000553:Ambulatory Care; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009664:Norway; D010352:Patient Dropouts / Q000523:psychology*; D010555:Personality Inventory; D011369:Professional-Patient Relations; D011446:Prospective Studies; D011613:Psychotherapy / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult