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Am J Psychiatry 1992; 149:358-362
Copyright © 1992 by American Psychiatric Association
An outcome study of psychotherapy for patients with borderline personality disorder
J Stevenson and R Meares
Department of Psychiatry, Westmead Hospital, New South Wales, Australia.
OBJECTIVE: This study evaluated the effectiveness of well-defined
outpatient psychotherapy for patients with borderline personality disorder.
METHOD: Thirty patients with borderline personality disorder diagnosed
according to the DSM-III criteria were given twice weekly outpatient
psychotherapy for 12 months by trainee therapists who were closely
supervised. The treatment approach was based on a psychology of self (this
term being used in its broad sense), and strong efforts were made to ensure
that all therapists adhered to the treatment model. Outcome measures
included frequency of use of drugs (both prescribed and illegal), number of
visits to medical professionals, number of episodes of violence and
self-harm, time away from work, number of hospital admissions, time spent
as an inpatient, score on a self-report index of symptoms, and number of
DSM-III criteria (weighted for frequency, severity, and duration)
fulfilled. RESULTS: The subjects showed statistically significant
improvement from the initial assessment to the end of the year of follow-up
on every measure. Moreover, 30% of the subjects no longer fulfilled the
DSM-III criteria for borderline personality disorder. This improvement had
persisted 1 year after the cessation of therapy. CONCLUSIONS: The results
suggest that a specific form of psychotherapy is of benefit for patients
with borderline personality disorder.
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