Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial

• Published in: British journal of psychiatry 2010-05, Vol.196 (5), p.389-395
• Main Authors: Doering, Stephan, Hörz, Susanne, Rentrop, Michael, Fischer-Kern, Melitta, Schuster, Peter, Benecke, Cord, Buchheim, Anna, Martius, Philipp, Buchheim, Peter
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antisocial personality disorder; Anxiety; Behavior change; Behavior modification; Borderline personality disorder; Borderline Personality Disorder - drug therapy; Borderline Personality Disorder - therapy; Clinical trials; Combined Modality Therapy; Community; Community Mental Health Services - methods; Comorbidity; Dominance; Female; Group psychotherapy; Humans; Inpatient care; Medical schools; Mental depression; Mental disorders; Mentally ill people; Middle Aged; Patient admissions; Personality; Psychiatric Status Rating Scales; Psychiatry; Psychopathology; Psychosocial factors; Psychosocial functioning; Psychotherapists; Psychotherapy; Psychotherapy - methods; Psychotropic Drugs - therapeutic use; Randomized controlled trials; Self-injury; Social interactions; Suicide; Suicides & suicide attempts; Therapists; Therapy; Transference; Transference (Psychology); Treatment needs; Treatment Outcome; Young Adult
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.bp.109.070177

Transference-focused psychotherapy is a manualised treatment for borderline personality disorder. To compare transference-focused psychotherapy with treatment by experienced community psychotherapists. In a randomised controlled trial (NCT00714311) 104 female out-patients were treated for 1 year with either transference-focused psychotherapy or by an experienced community psychotherapist. Significantly fewer participants dropped out of the transference-focused psychotherapy group (38.5% v. 67.3%) and also significantly fewer attempted suicide (d = 0.8, P = 0.009). Transference-focused psychotherapy was significantly superior in the domains of borderline symptomatology (d = 1.6, P = 0.001), psychosocial functioning (d = 1.0, P = 0.002), personality organisation (d = 1.0, P = 0.001) and psychiatric in-patient admissions (d = 0.5, P = 0.001). Both groups improved significantly in the domains of depression and anxiety and the transference-focused psychotherapy group in general psychopathology, all without significant group differences (d = 0.3-0.5). Self-harming behaviour did not change in either group. Transference-focused psychotherapy is more efficacious than treatment by experienced community psychotherapists in the domains of borderline symptomatology, psychosocial functioning, and personality organisation. Moreover, there is preliminary evidence for a superiority in the reduction of suicidality and need for psychiatric in-patient treatment.