Am J Psychiatry 156:1312-1321, September 1999
© 1999 American Psychiatric Association
Effectiveness of Psychotherapy for Personality Disorders
J. Christopher Perry, M.P.H., M.D.,
Elisabeth Banon, M.D., and
Floriana Ianni, M.D.
OBJECTIVE: The authors examined the evidence for the effectiveness of psychotherapy for personality disorders in psychotherapy outcome studies. METHOD: Fifteen studies were located that reported data on pretreatment-to-postreatment effects and/or recovery at follow-up, including three randomized, controlled treatment trials, three randomized comparisons of active treatments, and nine uncontrolled observational studies. They included psychodynamic/interpersonal, cognitive behavior, mixed, and supportive therapies. RESULTS: All studies reported improvement in personality disorders with psychotherapy. The mean pre-post effect sizes within treatments were large: 1.11 for self-report measures and 1.29 for observational measures. Among the three randomized, controlled treatment trials, active psychotherapy was more effective than no treatment according to self-report measures. In four studies, a mean of 52% of patients remaining in therapy recovered—defined as no longer meeting the full criteria for personality disorder—after a mean of 1.3 years of treatment. A heuristic model based on these findings estimated that 25.8% of personality disorder patients recovered per year of therapy, a rate sevenfold larger than that in a published model of the natural history of borderline personality disorder (3.7% recovered per year, with recovery of 50% of patients requiring 10.5 years of naturalistic follow-up). CONCLUSIONS: Psychotherapy is an effective treatment for personality disorders and may be associated with up to a sevenfold faster rate of recovery in comparison with the natural history of disorders. Future studies should examine specific therapies for specific personality disorders, using more uniform assessment of core pathology and outcome.
This article has been cited by other articles:
|
|
|
|
 
C. A. Roy, C. J. Perry, L. Luborsky, and E. Banon
Changes in Defensive Functioning in Completed Psychoanalyses: the Penn Psychoanalytic Treatment Collection
J Am Psychoanal Assoc,
April 1, 2009;
57(2):
399 - 415.
[Abstract]
[PDF]
|
|
|
|
|
|
|
F. Leichsenring and S. Rabung
Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis
JAMA,
October 1, 2008;
300(13):
1551 - 1565.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Howells, G. Krishnan, and M. Daffern
Challenges in the treatment of dangerous and severe personality disorder
Adv. Psychiatr. Treat.,
September 1, 2007;
13(5):
325 - 332.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. W E. Skodol, J. G. Johnson, P. Cohen, J. R. Sneed, and T. N. Crawford
Personality disorder and impaired functioning from adolescence to adulthood
The British Journal of Psychiatry,
May 1, 2007;
190(5):
415 - 420.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. N. Levy, R. H. Wasserman, L. N. Scott, S. E. Zach, C. N. White, N. M. Cain, C. Fischer, C. Eubanks Carter, J. F. Clarkin, and O. F. Kernberg
The Development of a Measure To Assess Putative Mechanisms of Change in the Treatment of Borderline Personality Disorder
J Am Psychoanal Assoc,
December 1, 2006;
54(4):
1325 - 1330.
[PDF]
|
|
|
|
|
|
|
S. Brown and F. Shapiro
EMDR in the Treatment of Borderline Personality Disorder
Clinical Case Studies,
October 1, 2006;
5(5):
403 - 420.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. Nathan
Self-harm: a strategy for survival and nodal point of change
Adv. Psychiatr. Treat.,
September 1, 2006;
12(5):
329 - 337.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Giesen-Bloo, R. van Dyck, P. Spinhoven, W. van Tilburg, C. Dirksen, T. van Asselt, I. Kremers, M. Nadort, and A. Arntz
Outpatient Psychotherapy for Borderline Personality Disorder: Randomized Trial of Schema-Focused Therapy vs Transference-Focused Psychotherapy.
Arch Gen Psychiatry,
June 1, 2006;
63(6):
649 - 658.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. Roffman, A. B. Simon, K. M. Prasad, C. J. Truman, J. Morrison, and C. L. Ernst
Neuroscience in Psychiatry Training: How Much Do Residents Need To Know?
Am J Psychiatry,
May 1, 2006;
163(5):
919 - 926.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Svartberg, T. C. Stiles, and M. H. Seltzer
Randomized, Controlled Trial of the Effectiveness of Short-Term Dynamic Psychotherapy and Cognitive Therapy for Cluster C Personality Disorders
Focus,
April 1, 2006;
4(2):
234.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. G. Johnson, M. B. First, P. Cohen, A. E. Skodol, S. Kasen, and J. S. Brook
Adverse Outcomes Associated With Personality Disorder Not Otherwise Specified in a Community Sample
Am J Psychiatry,
October 1, 2005;
162(10):
1926 - 1932.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Vinnars, J. P. Barber, K. Noren, R. Gallop, and R. M. Weinryb
Manualized Supportive-Expressive Psychotherapy Versus Nonmanualized Community-Delivered Psychodynamic Therapy for Patients With Personality Disorders: Bridging Efficacy and Effectiveness
Am J Psychiatry,
October 1, 2005;
162(10):
1933 - 1940.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Svartberg, T. C. Stiles, and M. H. Seltzer
Randomized, Controlled Trial of the Effectiveness of Short-Term Dynamic Psychotherapy and Cognitive Therapy for Cluster C Personality Disorders
Focus,
July 1, 2005;
3(3):
407 - 416.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Leichsenring and E. Leibing
The Effectiveness of Psychodynamic Therapy and Cognitive Behavior Therapy in the Treatment of Personality Disorders: A Meta-Analysis
Focus,
July 1, 2005;
3(3):
417 - 428.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Bond and J. C. Perry
Long-Term Changes in Defense Styles With Psychodynamic Psychotherapy for Depressive, Anxiety, and Personality Disorders
Focus,
July 1, 2005;
3(3):
429 - 437.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Josephs, E. Anderson, A. Bernard, K. Fatzer, and J. Streich
Assessing Progress in Analysis Interminable
J Am Psychoanal Assoc,
December 1, 2004;
52(4):
1185 - 1214.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Bond and J. C. Perry
Long-Term Changes in Defense Styles With Psychodynamic Psychotherapy for Depressive, Anxiety, and Personality Disorders
Am J Psychiatry,
September 1, 2004;
161(9):
1665 - 1671.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Svartberg, T. C. Stiles, and M. H. Seltzer
Randomized, Controlled Trial of the Effectiveness of Short-Term Dynamic Psychotherapy and Cognitive Therapy for Cluster C Personality Disorders
Am J Psychiatry,
May 1, 2004;
161(5):
810 - 817.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J C. Perry
Review: psychodynamic therapy and cognitive behavioural therapy are effective in the treatment of personality disorders
Evid. Based Ment. Health,
February 1, 2004;
7(1):
16 - 16.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Leichsenring and E. Leibing
The Effectiveness of Psychodynamic Therapy and Cognitive Behavior Therapy in the Treatment of Personality Disorders: A Meta-Analysis
Am J Psychiatry,
July 1, 2003;
160(7):
1223 - 1232.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Oldham
A 44-Year-Old Woman With Borderline Personality Disorder
JAMA,
February 27, 2002;
287(8):
1029 - 1037.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Gross, M. Olfson, M. Gameroff, S. Shea, A. Feder, M. Fuentes, R. Lantigua, and M. M. Weissman
Borderline Personality Disorder in Primary Care
Arch Intern Med,
January 14, 2002;
162(1):
53 - 60.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. L. Palmer
Dialectical behaviour therapy for borderline personality disorder
Adv. Psychiatr. Treat.,
January 1, 2002;
8(1):
10 - 16.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Adshead
Murmurs of discontent: treatment and treatability of personality disorder
Adv. Psychiatr. Treat.,
November 1, 2001;
7(6):
407 - 415.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. W. BATEMAN and P. FONAGY
Effectiveness of psychotherapeutic treatment of personality disorder
The British Journal of Psychiatry,
August 1, 2000;
177(2):
138 - 143.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Parry
Review: psychotherapy may be of benefit in personality disorders
Evid. Based Ment. Health,
May 1, 2000;
3(2):
50 - 50.
[Full Text]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1999
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
