Residential and day-hospital treatment for borderline personality disorder: a systematic review and meta-analysis
Background Residential and day-hospital psychotherapy are treatment modalities for patients with borderline personality disorder (BPD). A systematic overview of their effectiveness is lacking.
Aim To systematically examine the effects of residential and day-hospital psychotherapy for BPD (PROSPERO, CRD42020158557).
Method PsycINFO and PubMed, as well as previously published meta-analytic reviews, were searched for pre-post and controlled studies examining the effect of residential and day-hospital psychotherapy in adults with BPD.
Results After screening, 37 studies were included representing 5936 individuals with BPD. Pre-post studies showed an average effect size of residential or day-hospital psychotherapy from beginning to end of treatment on primary outcomes (Hedges’ g = 0.77; 95% CI: 0.67-0.87) and quality of life (g = 0.84; 95% CI: 0.54-1.13). The controlled studies showed a significant, but small effect of residential or day-hospital psychotherapy on primary outcome compared to outpatient controls (g = 0.27; 95% CI: 0.15-0.39), and on quality of life (g = 0.42; 95% CI: 0.13-0.72) compared to control conditions, at the end of treatment.
Conclusion Residential and day-hospital psychotherapy have a significant positive effect on pathology and quality of life of patients with BPD. More studies on long-term outcome are needed to determine effectiveness of residential and day-hospital psychotherapy.