Effectiveness of outpatient and community treatments for people with a diagnosis of 'personality disorder': systematic review and meta-analysis

• Published in: BMC psychiatry 2023-01, Vol.23 (1), p.57-57, Article 57
• Main Authors: Katakis, Panos, Schlief, Merle, Barnett, Phoebe, Rains, Luke Sheridan, Rowe, Sarah, Pilling, Steve, Johnson, Sonia
• Format: Article
• Language: English
• Subjects: Ambulatory medical care; Anxiety; Anxiety - therapy; Borderline personality disorder; Care and treatment; Clinical trials; Community psychiatric services; Community treatments; Diagnosis; Evaluation; Humans; Intervention; Medical diagnosis; Mental depression; Mental health care; Meta-analysis; Outpatient care facilities; Outpatients; Personality; Personality disorder; Personality Disorders; Post traumatic stress disorder; Psychiatry; Psychological interventions; Psychotherapy; Self destructive behavior; Suicides & suicide attempts; Systematic review
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-022-04483-0

Quality of care and access to effective interventions have been widely criticised as limited for people diagnosed with 'personality disorder' or who have comparable needs (described in some recent papers as "Complex Emotional Needs" (CEN). It is important to identify effective interventions and the optimal context and mode of delivery for people with CEN. We aimed to investigate the effectiveness of psychosocial interventions delivered in community and outpatient settings in treating symptoms associated with 'personality disorder', and the moderating effects of treatment-related variables. We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, HMIC, ASSIA for articles published in English, from inception to November 23, 2020. We included randomized controlled trials examining interventions provided in community or outpatient settings for CEN. The primary outcome was 'personality disorder' symptoms, while secondary outcomes included anxiety symptoms, depressive symptoms, and global psychiatric symptoms. Random-effects meta-analysis was conducted for each outcome, and meta-regression analysis was performed to assess the moderating effects of treatment characteristics. The quality of the studies and the degree of publication bias was assessed. We included 54 trials (n = 3716 participants) in the meta-analysis. We found a large effect size (g = 0.78, 95% CI: 0.56 to 1.01, p