Table 32Summary evidence profile for psychological therapy programmes versus treatment as usual: general outcomes

SymptomAngerAnxietyDepressionMental distressBorderline personality disorder symptomsEmployment related (no. years employment)General functioningLeaving treatment early because of side effects
TherapyDBTDBT (MBT at follow-up)DBT (MBT for self-rated)MBTDBT (MBT at follow-up)MBTMBTDBT MBT
Clinician-rated effect sizeSMD = −0.59 (−1.52, 0.35)SMD = −1.22 (−1.92, −0.52)SMD = −0.57 (−0.92, −0.22)*SMD = −0.39 (−1.03, 0.26)SMD = −0.6 (−2.34, 1.14)*RR = 0.61 (0.43, 0.86) (23% versus 39%)
 Quality of evidenceVery lowModerateModerateVery lowModerateModerate
 Number of studies/participants(K = 1; n = 19)(K = 1; n = 38)(K = 3; n = 133)(K = 1; n = 38)(K = 1; n = 20)(K = 5; n = 294)
Forest plotPsych 01.01Psych 01.02Psych 01.04Psych 01.9Psych 01.12Psych 01.16
Clinician-rated effect size at follow-up 1SMD = −0.91 (−1.99, 0.18) (12 months)SMD = −3.49 (−4.63, −2.36) (18 months)SMD = −2.09 (−2.93, −1.25) (18 months)
 Quality of evidenceModerateModerateVery low
 Number of studies/participants(K = 1; n = 15)(K = 1; n = 33)(K = 1; n = 36)
Forest plotPsych 01.01Psych 01.02Psych 01.9
Clinician-rated effect size at follow-up 2SMD = −0.59 (−1.52, 0.35) (24 months)SMD = −9.6 (−12.83, −6.38)* (5 years)WMD = −2 (−3.29, −0.71)* (5 years)SMD =−0.74 (−1.38, −0.1) (5 years)
 Quality of evidenceVery lowModerateModerateModerate
 Number of studies/participants(K = 1; n = 19)(K = 1; n = 41)(K = 1; n = 41)(K = 1; n = 41)
Forest plotPsych 01.01Psych 01.12Psych 01.14Psych 01.15
Self-rated effect sizeSMD = −0.7 (−1.53, 0.13)*SMD = −1.49 (−1.99, −0.99)*
 Quality of evidenceModerateModerate
 Number of studies/participants(K = 1; n = 24)(K = 3; n = 82)
Forest plotPsych 01.03Psych 01.05
Self-rated effect size at follow-upSMD = −1.15 (−1.85, −0.45) (18 months)
 Quality of evidenceModerate
 Number of studies/participants(K = 1; n = 38)
Forest plotPsych 01.06
*

Based on skewed data.

2 different measures of anxiety were reported which the GDG did not consider could be combined (HARS and STAI - state anxiety). Since the effect sizes from both measures were very similar, only one is reported here (STAI - state anxiety).

From: 5, PSYCHOLOGICAL AND PSYCHOSOCIAL TREATMENTS IN THE MANAGEMENT OF BORDERLINE PERSONALITY DISORDER

Cover of Borderline Personality Disorder
Borderline Personality Disorder: Treatment and Management.
NICE Clinical Guidelines, No. 78.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2009.
Copyright © 2009, The British Psychological Society & The Royal College of Psychiatrists.

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