Male, 20 years old, was brought by family members after thre | Figure 1

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Psychiatry

Male, 20 years old, was brought by family members after three suicide attempts in the past 2 days.

He was diagnosed with Borderline Personality Disorder at 18 and has been cutting on and off for about a year, this "cutting crisis" (name given by the patient) occurred after he woke up at the hospital after a stomach lavage, according to the patient "he was frustrated he isn't allowed to die".

He wasn't under any medicatios due to the parents refusing to accept any treatments that were pharmacological.

The patient is currently on suicide watch.

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Background

People affected by borderline personality disorder (BPD) often have difficulties with controlling their impulses and emotions. They may have a poor self‐image, experience rapid changes in mood, harm themselves and find it hard to engage in harmonious interpersonal relationships. Different types of psychological treatments ('talking treatments') have been developed to help people with BPD.

Objective

This review summarises what we currently know about the effect of psychotherapy in people with BPD.

Methods

We compared the effects of psychological treatments on people affected by BPD who did not receive treatment or who continued their usual treatment, were on a waiting list or received active treatment.

Findings

We searched for relevant research articles and found 75 trials (4507 participants, mostly female, mean age ranging from 14.8 to 45.7 years). The trials examined a wide variety of psychological treatments (over 16 different types).

Psychotherapy compared with usual treatment Psychotherapy reduced the severity of BPD symptoms and suicidality and may reduce self‐harm and depression whilst also improving psychological functioning compared to usual treatment.

Conclusions
In general, psychotherapy may be more effective than usual treatment in reducing BPD symptom severity, self‐harm, suicide‐related outcomes and depression, whilst also improving psychosocial functioning. However, only the decrease in BPD symptom severity was found to be at a clinically important level. DBT appears to be better at reducing BPD severity, self‐harm, and improving psychosocial functioning compared to usual treatment and MBT appears more effective than usual treatment at reducing self‐harm and suicidality. However, we are still uncertain about these findings as the quality of the evidence is low.