title: To what extent are specific psychotherapies for borderline personality disorders efficacious? A systematic review of published randomised controlled trials.
abstract: BACKGROUND
  Over the past 20 years, several studies have established the efficacy of different forms of psychotherapy for borderline personality disorders (BPD). However, existing research has used a wide range of outcomes measures which makes it difficult to quantify data and to compare interventions. This review has been designed to analyse the evidence from randomized controlled trials (RCT) through a qualitative approach.
  
  
  METHODS
  A systematic review of published RCT on specific psychotherapies for BPD has been undertaken to find relevant literature from online PsycINFO, ISI Web of Knowledge and Medline databases. An analysis of variability in primary outcomes, dropout patients and those who do not enter treatment has been conducted to assess if a wide range of variation could show any potential bias.
  
  
  RESULTS
  There is a substantial variation between the studies in primary outcomes, such as suicide attempts (7.4- 33.9%), and specially in dropout patients (6.7-47.4%) and those who do not enter treatment (17.6-63.6%). Globally, specific psychotherapy for BPD, at least in a 40% of patients who demand treatment, would not be efficacious.
  
  
  CONCLUSIONS
  The overall efficacy of specific therapies for BPD is promising. However, the variability of results raise questions about potential bias. Future studies should investigate new therapeutic approaches to allow the management of more severe and refractory patients.
authors.affiliation: Instituto de Neuropsiquiatría y Adicciones (INAD), Centre Emili Mira Parc de Salut Mar, Barcelona, Spain. Flanamoliner@parcdesalutmar.cat
authors.forename: Fernando
authors.initials: F
authors.lastname: Lana
authors.forename: Ma Isabel
authors.initials: MI
authors.lastname: Fernández-San Martín
mesh_terms: D001883:Borderline Personality Disorder / Q000628:therapy*; D006801:Humans; D011613:Psychotherapy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome