Efficacy of cognitive rehabilitation on psychosocial functioning in Borderline Personality Disorder: a randomized controlled trial

Juan C Pascual, Nerea Palomares, Ángela Ibáñez, Maria J Portella, Rocío Arza, Raquel Reyes, Albert Feliu-Soler, Marina Díaz-Marsá, Jerónimo Saiz-Ruiz, Joaquim Soler, Jose L Carrasco, Juan C Pascual, Nerea Palomares, Ángela Ibáñez, Maria J Portella, Rocío Arza, Raquel Reyes, Albert Feliu-Soler, Marina Díaz-Marsá, Jerónimo Saiz-Ruiz, Joaquim Soler, Jose L Carrasco

Abstract

Background: Follow-up studies revealed that subjects with borderline personality disorder (BPD) present high rates of clinical remission, although psychosocial functioning often remains impaired. The aim of this study is to evaluate the efficacy of a cognitive rehabilitation intervention versus a psychoeducational program on psychosocial functioning in subjects with BPD.

Methods: A multicenter, randomized, and positive-controlled clinical trial was conducted. Seventy outpatients with BPD were randomized to cognitive rehabilitation or psychoeducational group interventions. Participants were evaluated after completion of the intervention period (16 weeks) and after the follow-up period (6 months). Psychosocial functioning, clinical and neuropsychological outcomes were evaluated.

Results: No main effects of group or group x time were observed on functionality but a significant effect of time was found. Post-hoc analyses showed that only cognitive rehabilitation increased psychosocial functioning significantly at endpoint. Psychoeducation showed a significant enhancement of depressive symptoms.

Conclusions: Cognitive rehabilitation and psychoeducational interventions appeared to show good efficacy in improving disabilities in daily life in subjects with BPD. These interventions are easily implemented in mental health settings and have the advantage of improving general functioning and clinical symptoms.

Trial registration: Clinicaltrials.gov: NCT02033044. Registered 9 January 2014.

Figures

Fig. 1
Fig. 1
The CONSORT diagram shows the randomization of patients to cognitive rehabilitation or psychoeducation and the progress through the study
Fig. 2
Fig. 2
General functional improvement measured by FAST scores in CG and PE groups in pre-, post- and 6 months follow-up measurements. Note Fig. 2: Rounded and squared dots represent means and bars, standard errors. CR = Cognitive Rehabilitation; PE = Psychoeducational intervention. A time effect was observed in the HLM analysis [F(2, 41.14) = 7.54, p = .002]. Post hoc analyses showed that FAST only improved significantly in the CR condition (p = .018)

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