Eight-year prospective follow-up of mentalization-based treatment versus structured clinical management for people with borderline personality disorder.

Abstract

Participants (n ϭ 134) treated in a randomized controlled trial with mentalization-based treatment (MBT) compared with structured clinical management were followed up for 8 years after starting treatment in terms of the initial primary outcome of the trial-namely, suicide attempts, self-harm, and hospitalization-as well as service use and functional outcomes. Patients in the study group were interviewed by research assistants who remained masked to the original group allocation. Interviews were scheduled annually. Of the original participants, 98 (73%) agreed to participate. Overall, the beneficial outcomes at the end of treatment were maintained in both groups. Over the follow-up period, the number of patients who continued to meet the primary recovery criteria was significantly higher in the MBT group (74% vs. 51%). Use of most other services was comparable. Participants treated with MBT showed better functional outcomes in terms of being more likely to be engaged in purposeful activity and reporting less use of professional support services and social care interventions.

“Yes, there is actually hope!”—A qualitative investigation of how patients experience mentalization-based psychoeducation tailored for borderline personality disorder.

“…An increasing evidence-base supports specifically structured psychotherapies as a means of increasing the treatment potential for poorly functioning patients with BPD (Storebø et al, 2020). Positive results include low drop-out rates and sustained long-term effects for clinically severe conditions (Bateman, Constantinou, Fonagy, & Holzer, 2020; Bateman & Fonagy, 2013a; Kvarstein et al, 2018). Moreover, in later years, a growing base of qualitative research exploring the subjective experiences of BPD patients, has provided further understanding of personality disorder and subjective treatment experiences (Kverme, Natvik, Veseth, & Moltu, 2019; Morken, 2019a; Ng, Townsend, Miller, Jewell, & Grenyer, 2019).…”

Mentalization-based treatment.

“…A Cochrane systematic review of all psychological treatments for BPD (Storebø et al, 2020) found that MBT and DBT had the highest number of primary trials and MBT the longest follow-up of outcome of treatment with a comparison group. MBT follow-up shows that gains made at the end of treatment are maintained for at least 5 years (Bateman, Constantinou, et al, 2021;. Overall, the review concluded that MBT reduced self-harm and suicide at end of treatment and at long-term follow-up, with MBT having the highest effect size (g = 1.032) on suicidality of any treatment.…”

“…Research trials show that improvements start at around 6 months of treatment, and there is little, if any, reemergence of earlier symptoms later in treatment, with most gains being achieved by 1 year. Follow-up of patients treated with MBT shows that gains made at 18 months are maintained over at least 5 years (Bateman, Constantinou, et al, 2021;, but it remains unclear if these long-term rehabilitative effects of treatment are in process after only 1 year of treatment.…”

Exploring the Utility of Neurostimulation Therapies in the Treatment of Borderline Personality Disorder

“…Finally, several of the TMS studies had very small sample sizes and were likely to have been underpowered. Most of the studies had a relatively short follow-up periods; hence, it was unclear whether the benefits reported after these neuromodulation interventions lead to the sustained improvements in the longer term as has been shown for psychotherapeutic interventions 63 …”