Symptom, alexithymia and self-image outcomes of Mentalisation-based treatment for borderline personality disorder: a naturalistic study

J Löf, D Clinton, V Kaldo, G Rydén, J Löf, D Clinton, V Kaldo, G Rydén

Abstract

Background: Mentalisation-based treatment (MBT) in borderline personality disorder (BPD) has a growing evidence base, but there is a lack of effectiveness and moderator studies. The present study examined the effectiveness of MBT in a naturalistic setting and explored psychiatric and psychological moderators of outcome.

Method: Borderline and general psychiatric symptoms, suicidality, self-harm, alexithymia and self-image were measured in a group of BPD patients (n = 75) receiving MBT; assessments were made at baseline, and subsequently after 6, 12 and 18 months (when treatment ended). Borderline symptoms were the primary outcome variable.

Results: Borderline symptoms improved significantly (d = 0.79, p < .001), as did general psychiatric symptoms, suicidality, self-harm, self-rated alexithymia and self-image. BPD severity or psychological moderators had no effect on outcome. Younger patients improved more on self-harm, although this could be explained by the fact that older patients had considerably lower baseline self-harm.

Conclusions: MBT seems to be an effective treatment in a naturalistic setting for BPD patients. This study is one of the first studies of MBT showing that outcomes related to mentalisation, self-image and self-rated alexithymia improved. Initial symptom severity did not influence results indicating that MBT treatment is well adapted to patients with severe BPD symptoms.

Trial registration: The study was retrospectively registered 25 September 2017 in the ClinicalTrials.gov PRS registry, no. NCT03295838 .

Keywords: Alexithymia; Borderline personality disorder; Mentalization-based treatment; Pragmatic clinical trials as topic; Psychotherapy; Treatment outcome.

Conflict of interest statement

Ethics approval and consent to participate

All patients signed a written consent form for participation in the present study. Ethics approval was obtained from the Stockholm Regional Ethics Board (http://www.epn.se/media/1105/ichgcp.pdf): “Kliniska effekter och riskfaktorer vid strukturerat omhändertagande av. borderlinepersonlighetsstörning”, DNR 2011/1909–31/3. The study adhered to the principles of the Declaration of Helsinki.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Patient progression through the MBT programme and response rate to primary outcome self-report

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