Dialectical Behavior Therapy in suicidal patients with borderline personality disorder: A pilot randomized controlled trial in Taiwan

Abstract

AbstractBackground:Borderline personality disorder (BPD) is associated with considerable morbidity and mortality. Suicidality and self-injury are common. This study aimed to examine the implementation of Dialectical Behavior Therapy (DBT) in the local Chinese sample.Method:This is a single-blind randomized controlled trial recruited patients diagnosed with BPD with at least two episodes of suicidal or non- suicidal self-injurious episodes in the past 5 years. These patients were randomly assigned to one year of either DBT or psychotherapy delivered by community treatment experts in suicide prevention. Primary outcomes, assessed at 4-month intervals over the treatment year, were frequency of suicide attempts and episodes of non- suicidal self-injury. Psychological distress including depression, anxiety, hopelessness, suicidal ideations, and quality of life were also measured.Results:Of the 150 patients with borderline personality disorder referred and screened, 60 participated in the trial. Reductions in self-harm behaviors, medical utilizations due to suicidal ideations or suicidal attempts, borderline symptoms, and psychological distress were found in both groups. However, no between-group differences were noted at the end of treatments.Conclusions:Our results suggest that BPD patients with suicidal attempts in a publicly funded health care system with limited resources benefited equally from DBT and treatment delivered by suicide prevention experts in Taiwan.Trial registration:Clinical Trial IdentifierNCT01952405. First Submitted: September 6, 2013