Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies

Background: This meta-analytic review is the first to synthesize findings from prospective research on the long-term course of borderline personality disorder in adult clinical populations. Methods: Systematic searches were conducted in Medline, PsycINFO, PsycArticles, PubMed, and Scopus within the...

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Authors: Álvarez Tomás, Irene, Ruiz Rodríguez, José, Guilera Ferré, Georgina, Bados López, Arturo
Format: article
Status:Published version
Publication Date:2019
Country:España
Institution:Universidad de Barcelona
Repository:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/175985
Online Access:https://hdl.handle.net/2445/175985
Access Level:Open access
Keyword:Trastorns límits de la personalitat
Metaanàlisi
Borderline personality disorder
Meta-analysis
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spelling Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studiesÁlvarez Tomás, IreneRuiz Rodríguez, JoséGuilera Ferré, GeorginaBados López, ArturoTrastorns límits de la personalitatMetaanàlisiBorderline personality disorderMeta-analysisBackground: This meta-analytic review is the first to synthesize findings from prospective research on the long-term course of borderline personality disorder in adult clinical populations. Methods: Systematic searches were conducted in Medline, PsycINFO, PsycArticles, PubMed, and Scopus within the period 1990-2017. Inclusion criteria were: (1) adult BPD sample diagnosed by a validated, semi-structured interview; (2) at least two prospective assessments of outcomes; and (3) follow-up period ≥ 5 years. Quality of evidence was rated with the Systematic Assessment of Quality in Observational Research (SAQOR). Four outcomes were meta-analysed using mixed-effect methods: remission from BPD diagnosis, completed suicide, depressive symptoms, and functioning. Potential moderators regarding the natural course and the initial treatment received were studied. Results: Eleven studies met the inclusion criteria, with 837 participants from nine countries being followed. Between 50% and 70% of the BPD patients achieved remission in the long-term. Significant reductions in depression and functional impairment were also found. Mean suicide rate ranged from 2% to 5%. Younger age was associated with a higher likelihood of remission. Being female was correlated with lower functional improvement. Despite some positive trends, there were no significant associations between treatment moderators and the long-term outcome. Conclusions: Findings suggest that the course of BPD is characterized by symptomatic amelioration and a slight functional improvement in the long-term. Age and gender modulate the long-term prognosis and should be considered to adapt treatment resources. Further research is required to draw robust conclusions on the long-term effects of psychotherapeutic interventions.Cambridge University Press2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/175985Articles publicats en revistes (Psicologia Clínica i Psicobiologia)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.eurpsy.2018.10.010European Psychiatry, 2019, vol. 56, num. 1, p. 75-83https://doi.org/10.1016/j.eurpsy.2018.10.010(c) Elsevier Masson SAS, 2019info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1759852026-05-27T06:46:51Z
dc.title.none.fl_str_mv Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
title Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
spellingShingle Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
Álvarez Tomás, Irene
Trastorns límits de la personalitat
Metaanàlisi
Borderline personality disorder
Meta-analysis
title_short Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
title_full Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
title_fullStr Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
title_full_unstemmed Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
title_sort Long-term clinical and functional course of Borderline Personality Disorder: A meta-analysis of prospective studies
dc.creator.none.fl_str_mv Álvarez Tomás, Irene
Ruiz Rodríguez, José
Guilera Ferré, Georgina
Bados López, Arturo
author Álvarez Tomás, Irene
author_facet Álvarez Tomás, Irene
Ruiz Rodríguez, José
Guilera Ferré, Georgina
Bados López, Arturo
author_role author
author2 Ruiz Rodríguez, José
Guilera Ferré, Georgina
Bados López, Arturo
author2_role author
author
author
dc.subject.none.fl_str_mv Trastorns límits de la personalitat
Metaanàlisi
Borderline personality disorder
Meta-analysis
topic Trastorns límits de la personalitat
Metaanàlisi
Borderline personality disorder
Meta-analysis
description Background: This meta-analytic review is the first to synthesize findings from prospective research on the long-term course of borderline personality disorder in adult clinical populations. Methods: Systematic searches were conducted in Medline, PsycINFO, PsycArticles, PubMed, and Scopus within the period 1990-2017. Inclusion criteria were: (1) adult BPD sample diagnosed by a validated, semi-structured interview; (2) at least two prospective assessments of outcomes; and (3) follow-up period ≥ 5 years. Quality of evidence was rated with the Systematic Assessment of Quality in Observational Research (SAQOR). Four outcomes were meta-analysed using mixed-effect methods: remission from BPD diagnosis, completed suicide, depressive symptoms, and functioning. Potential moderators regarding the natural course and the initial treatment received were studied. Results: Eleven studies met the inclusion criteria, with 837 participants from nine countries being followed. Between 50% and 70% of the BPD patients achieved remission in the long-term. Significant reductions in depression and functional impairment were also found. Mean suicide rate ranged from 2% to 5%. Younger age was associated with a higher likelihood of remission. Being female was correlated with lower functional improvement. Despite some positive trends, there were no significant associations between treatment moderators and the long-term outcome. Conclusions: Findings suggest that the course of BPD is characterized by symptomatic amelioration and a slight functional improvement in the long-term. Age and gender modulate the long-term prognosis and should be considered to adapt treatment resources. Further research is required to draw robust conclusions on the long-term effects of psychotherapeutic interventions.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/175985
url https://hdl.handle.net/2445/175985
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.eurpsy.2018.10.010
European Psychiatry, 2019, vol. 56, num. 1, p. 75-83
https://doi.org/10.1016/j.eurpsy.2018.10.010
dc.rights.none.fl_str_mv (c) Elsevier Masson SAS, 2019
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Elsevier Masson SAS, 2019
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Cambridge University Press
publisher.none.fl_str_mv Cambridge University Press
dc.source.none.fl_str_mv Articles publicats en revistes (Psicologia Clínica i Psicobiologia)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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