Psychological Medicine



Five-year outcome of outpatient psychotherapy with borderline patients


JANINE STEVENSON a1c1, RUSSELL MEARES a1 and ROBERTO D'ANGELO a1
a1 Department of Psychological Medicine, The University of Sydney, Westmead Hospital, Darcy Road, Westmead, NSW 2145, Australia

Article author query
stevenson j   [PubMed][Google Scholar] 
meares r   [PubMed][Google Scholar] 
d'angelo r   [PubMed][Google Scholar] 

Abstract

Background. Borderline personality disorder (BPD) is a serious mental illness. Due to scepticism about the effectiveness of its treatment, the care of these patients is neglected. In this study we evaluated the effect of treatment 5 years after its ending, of patients with BPD.

Method. Thirty subjects were treated twice weekly for 1 year by psychotherapy based on the ‘Conversational Model’ of Hobson. Outcome measures included time in hospital, number of episodes of violence and self-harm, number of medical appointments, drug use and work history. A ‘morbidity budget’ made up of these items was collated for the year before treatment, the year following treatment, and for the year preceding the 5-year follow-up. Additional measures included DSM-III criteria and a self-report of symptoms. These outcomes were compared to a hypothetical natural history of BPD constructed from the DSM scores of 150 borderline patients aged between 18 and 52 years.

Results. Except for one measure, the improvements evident 1 year following treatment were maintained 4 years later. This improvement was not predicted by the hypothetical natural history.

Conclusion. A particular form of treatment of BPD has relatively long-lasting, beneficial effects.


Correspondence:
c1 Dr Janine Stevenson, Department of Psychological Medicine, The University of Sydney, Westmead Hospital, Darcy Road, Westmead, NSW 2145, Australia. (Email: jstevens@mail.usyd.edu.au)


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