Personality Limit Disorder: Systematic Review of Interventions
TLP: Comparison of treatments
DOI:
https://doi.org/10.33898/rdp.v30i113.274Keywords:
personality limitation disorder, psychotherapies, randomized controlled trial, reviewAbstract
Borderline Personality Disorder (BPD) is a complex and heterogeneous syndrome characterized primarily by affective, interpersonal, and self-image instability. During the last years several trials have evaluated the effectiveness of different psychotherapeutic strategies to treat this disorder. The objective of the present study is to provide an updated review to analyze the evidence from Randomized Controlled Trials (RCTs) through a qualitative approach. Scientific evidence suggests that structured psychotherapies contribute significantly to the improvement of borderline pictures, both symptomatology and functioning. Although there are differences in the factors that affect each intervention, that can contribute to the choice of the most appropriate treatment, achieving a dimensional and functional vision of the symptom in a context Centered-patient health.
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References
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3th Ed., text Rev.). Washington, DC: American Psychiatric Publishing.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th Ed., text Rev.). Washington, DC: American Psychiatric Publishing.
American Psychiatric Association (2001). Practice guideline for the treatment of patients with borderline personality disorders, vol.110. Washington, DC: American Psychiatric Publishing.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed., text Rev.). Washington, DC: American Psychiatric Publishing.
Barrachina, J., Pascual, J. C., Ferrer, M., Soler, J., Rufat, M. J., Andión, O., Tiana, T., Martín-Blanco, A., Casas,
M. y Pérez, V. (2011). Axis II comorbidity in borderline personality disorder is influenced by sex, age, and clinicalseverity. Comprehensive Psychiatry, 52(6), 725-730. https://bit.ly/2RVbmpJ
Bateman, A. y Fonagy, P. (1999). Effectiveness of partial hospitalization in the treatment of borderline personality disorder: a randomized controlled trial. American Journal of Psychiatry, 156(10), 1563-1569. https://doi.org/10.1176/ajp.156.10.1563
Bateman, A. y Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. American Journal of Psychiatry, 166(12), 1355-1364. https://doi.org/10.1176/appi.ajp.2009.09040539
Bateman, A., O’Connell, J., Lorenzini, N., Gardner, T. y Fonagy, P. (2016). A randomised controlled trial of mentalization-based treatment versus structured clinical management for patients with comorbid borderline personality disorder and antisocial personality disorder. BMC psychiatry, 16(1), 304. https://doi.org/10.1186/s12888-016-1000-9
Bedics, J. D., Atkins, D. C., Comtois, K. A. y Linehan, M. M. (2012). Treatment differences in the therapeutic relationship and introject during a 2-year randomized controlled trial of dialectical behavior therapy versus nonbehavioral psychotherapy experts for borderline personality disorder. Journal of Consulting and Clinical Psychology, 80(1), 66. https://doi.org/10.1037/a0026113
Black, D. W., Blum, N., Pfohl, B. y Hale, N. (2004). Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction, and prevention. Journal of personality disorders, 18(3), 226-239. https://doi.org/10.1521/pedi.18.3.226.35445
Blum, N., St. John, D., Pfohl, B., Stuart, S., McCormick, B., Allen, J., ...y Black, D. W. (2008). Systems Training for Emotional Predictability and Problem Solving (STEPPS) for outpatients with borderline personality disorder: a randomized controlled trial and 1-year follow-up. American Journal of Psychiatry, 165(4), 468- 478. https://doi.org/10.1176/appi.ajp.2007.07071079
Carter, G. L., Willcox, C. H., Lewin, T. J., Conrad, A. M. y Bendit, N. (2010). Hunter DBT project: randomized controlled trial of dialectical behaviour therapy in women with borderline personality disorder. Australian & New Zealand Journal of Psychiatry, 44(2), 162-173. https://doi.org/10.3109%2F00048670903393621
Clarkin, J. F., Levy, K. N., Lenzenweger, M. F. y Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: a multiwave study. American Journal of Psychiatry, 164(6), 922-928. https://doi.org/10.1176/ajp.2007.164.6.922
Doering, S., Hörz, S., Rentrop, M., Fischer-Kern, M., Schuster, P., Benecke, C., ... y Buchheim, P. (2010). Transference-focused psychotherapy v. treatment by community psychotherapists for borderline personality disorder: randomised controlled trial. The British Journal of Psychiatry, 196(5), 389-395. https://doi.org/10.1192/bjp.bp.109.070177
Esbec, E. y Echeburúa, E. (2014). La evaluación de los trastornos de la personalidad según el DSM-5: recursos y limitaciones. Terapia Psicológica, 32(3), 255-264. Recuperado de: https://bit.ly/2XVB5nu
Farrell, J. M., Shaw, I. A. y Webber, M. A. (2009). A schema-focused approach to group psychotherapy for outpatients with borderline personality disorder: a randomized controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 40(2), 317-328. https://doi.org/10.1016/j.jbtep.2009.01.002
Fernández-Guerrero, M. J. y Palacios-Vicario, B. (2017). El trastorno límite de personalidad en la producción científica publicada en revistas editadas en España. Clínica y Salud, 28(3), 147-153. https://bit.ly/32bYFLK
García, M., Martín, M. y Otín, R. (2010). Tratamiento integral del trastorno límite de personalidad. Revista de la Asociación Española de Neuropsiquiatría, 30(2), 263-278. Recuperado de: https://bit.ly/2XubWMa
Giesen-Bloo, J., Van Dyck, R., Spinhoven, P., Van Tilburg, W., Dirksen, C., Van Asselt, T., ... y Arntz, A. (2006). Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of general psychiatry, 63(6), 649-658. https://doi.org/10.10017archpsyc.63.6.649
González Robles, A., García Palacios, A., Molinari, G. y Del Río González, E. (2015). DSM-5: avances en la clasificación y el diagnóstico de los trastornos mentales. Ágora de Salud, 1, 115-126. http://dx.doi.org/10.6035/AgoraSalut.2015.1.8
Grupo de trabajo de la guía de práctica clínica sobre trastorno límite de la personalidad. Fórum de Salud Mental y AIAQS (2011). Guía de práctica clínica sobre trastorno límite de la personalidad. Barcelona: Agènciad’Informació, Avaluació i Qualitat en Salut.
Gutiérrez, F. y Vilar, A. (2014). Trastornos de la personalidad en el DSM-5. Cuadernosde Medicina Psicosomática y Psiquiatría, 110, 49-52.
Kernberg, O. F. y Mischels, R. (2009). Borderline personality disorder. American Journal of Psychiatry, 166, 505- 508. https://doi.org/10.1176/appi.ajp.2009.09020263
Kjaer, J. N., Biskin, R., Vestergaard, C. H. y Munk-Jørgensen, P. (2015). A nationwide study of mortality in patients with borderline personality disorder. European Psychiatry, 30, 202. https://bit.ly/2xz2oVz
Koons, C. R., Robins, C. J., Tweed, J. L., Lynch, T. R., Gonzalez, A. M., Morse, J. Q., ... y Bastian, L. A. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior therapy, 32(2), 371-390. https://bit.ly/32e7uVg
Kramer, U., Pascual Leone, A., Berthoud, L., Roten, Y., Marquet, P., Kolly, S., ... y Page, D. (2016). Assertive anger mediates effects of dialectical behaviour informed skills training for borderline personality disorder: A randomized controlled trial. Clinical psychology & psychotherapy, 23(3), 189-202. https://bit.ly/32apDDE
Leichsenring, F., Leibing, E., Cruse, J., New, A. S. y Leweke F. (2011). Borderline personality disorder. Lancet, 377, 74-84. https://bit.ly/2L4mOP0
Leppänen, V., Hakko, H., Sintonen, H. y Lindeman, S. (2016). Comparing effectiveness of treatments for borderline personality disorder in communal mental health care: The Oulu BPD Study. Community mental health journal, 52(2), 216-227. https://doi.org/10.1007/s10597-015-9866-4
Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J. y Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug dependence. The American journal on addictions, 8(4), 279-292. https://doi.org/10.1080/105504999305686
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., ... y Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of general psychiatry, 63(7), 757-766. https://doi.org/10.1001/archpsyc.63.7.757
McMain, S. F., Links, P. S., Gnam, W. H., Guimond, T., Cardish, R. J., Korman, L. y Streiner, D. L. (2009). A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. American Journal of Psychiatry, 166(12), 1365-1374. https://doi.org/10.1176/appi.ajp.2009.09010039
Mosquera, D. y González, A. (2011). Del apego temprano a los síntomas del trastorno límite de personalidad. Revista Digital de Medicina Psicosomática y Psicoterapia. Recuperado en: https://bit.ly/30hlKuN
Organización Mundial de la Salud (OMS) (1992). Décima revisión de la clasificación internacional de las enfermedades. Trastornos mentales y del comportamiento. Descripción clínicas y pautas para el diagnós- tico, Madrid, España: Méditor.
Palomares, N., McMaster, A., Díaz-Marsá, M., de la Vega, I., Montes, A. y Carrasco, J. L. (2016). Comorbilidad con el eje II y funcionalidad en pacientes graves con trastorno límite de la personalidad. Actas Españolas de Psiquiatría, 44(6), 212-21.
Pascual, J. C., Palomares, N., Ibáñez, Á., Portella, M. J., Arza, R., Reyes, R., ... y Carrasco, J. L. (2015). Efficacy of cognitive rehabilitation on psychosocial functioning in Borderline Personality Disorder: a randomized controlled trial. BMC psychiatry, 15(1), 255. https://doi.org/10.1186/s12888-015-0640-5
Romero-Cabello, R., González-Salas, I. C. y Sánchez, C. J. (2016). Trastorno de la personalidad: un desafío en la relación médico-paciente. Atención Familiar, 23(4), 155-159. https://doi.org/10.1016/j.af.2016.10.005
Sansone, R. A. y Sansone, L. A. (2015). Borderline personality disorder in the medical setting: suggestive behaviors, syndromes, and diagnoses. Innovations in clinical neuroscience, 12(7-8), 39. Recuperado de: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558791/pdf/icns_12_7-8_39.pdf
Semerari, A. y Dimaggio, G. (2008). Los trastornos de la personalidad. Modelos y tratamientos. Bilbao, España: Descleé de Brouwer.
Soler, J., Pascual, J. C., Tiana, T., Cebrià, A., Barrachina, J., Campins, M. J., ... y Pérez, V. (2009). Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial. Behaviour research and therapy, 47(5), 353-358. https://doi.org/10.1016/j.brat.2009.01.013
Turner, R. M. (2000). Naturalistic evaluation of dialectical behavior therapy-oriented treatment for borderline personality disorder. Cognitive and Behavioral Practice, 7(4), 413-419. https://bit.ly/2XrLjr9
Verheul, R., Van Den Bosch, L. M., Koeter, M. W., De Ridder, M. A., Stijnen, T. y Van Den Brink, W. (2003). Dialectical behaviour therapy for women with borderline personality disorder. The British Journal of Psychiatry, 182(2), 135-140. https://doi.org/10.1192/bjp.182.2.135
Zanarini, M. C., Frankenburg, F. R., Hennen, J., Reich, D. B. y Silk, K. R. (2005). The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up. Journal of personality disorders, 19(5), 505-523. https://doi.org/10.1521/pedi.2005.19.5.505
Zanarini, M. y Jager-Hyman, S. (2009). Dissociation in Borderline Personality Disorder. En, P. Dell y J. O’Neil, Dissociation and the Dissociative Disorders. DSM-V and Beyond (pp 487-494). Nueva York, NY: Taylor & Francis.
