Störungsspezifische Psychotherapie der Borderline-Persönlichkeitsstörung: Evidenz zu Dialektisch-Behavioraler und Mentalisierungsbasierter Therapie

Background: Several disorder-specific psychotherapy methods have been developed for the treatment of borderline personality disorder (BPD). For this reason people with BPD are no longer regarded as untreatable. To date, dialectical behavior therapy (DBT) according to Linehan and the mentalization-based treatment (MBT) according to Fonagy have been most intensively studied. Objective: The current evidence for DBT and MBT is surveyed. In addition, adaptations of the standard DBT and MBT treatments for specific patient groups are outlined along with findings from evaluation studies. Material and methods: The current evidence from randomized controlled trials of DBT and MBT in BPD patients is summarized based on the current Cochrane review. In addition, some relevant studies are highlighted, which showed essential new developments in this field. Results: In meta-analyses both DBT and MBT showed clear effects for many levels of expression of symptoms, especially BPD severity, suicidality and self-harm behavior. Several adaptations of both are now available, especially for a variety of comorbid disorders as well as adolescents and relatives of people with BPD. Conclusion: The current evidence supports the use of disorder-specific methods, such as DBT and MBT for treatment of BPD, while the study situation for other methods is still scarce. Evidence is emerging that adolescents with BPD or severe BPD symptoms can also benefit from early interventions.