Free Paper ISSPD Congress 2023

Predicting treatment effects of specialised psychotherapies for people with borderline personality disorder (17690)

Johanne Pereira Ribeiro 1 2 , Mickey Kongerslev 2 3 , Erik Simonsen 3 4 , Pim Cuijpers 5 , Eirini Karyotaki 5 , Mie Sedoc-Jørgensen 1 , Jutta Stoffers-Winterling 6 , Richard Kirubakaran 7 , Anthony Bateman 8 9 10 , Klaus Lieb 6 , Ole Jakob Storebø 1 2
  1. Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
  2. Department of Psychology, University of Southern Denmark, Odense, Denmark
  3. District Psychiatric Services, Region Zealand Mental Health Services, Roskilde, Denmark
  4. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
  5. Department of Clinical, Neuro and Developmental Psychology, Vrije University, Amsterdam, The Netherlands
  6. Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
  7. Prof BV Moses Centre for Evidence-Informed Healthcare and Health Policy, Vellore, India
  8. Anna Freud Centre, London, United Kingdom
  9. University College, London, United Kingdom
  10. University of Copenhagen, Copenhagen, Denmark

Background: Psychotherapy is the recommended treatment for borderline personality disorder in guidelines worldwide and the beneficial effects of psychotherapy are undisputed. Diagnostic criteria however makes for a largely heterogenic patient group, and people with borderline personality disorder do not necessarily present clinically with the same symptomatic behaviors. Some people might have a better effect of some types of psychotherapy compared to others but information regarding predictors and moderators of treatment effects across psychotherapies is yet to be unfolded.

Objective: The IPD-BPD project investigates whether characteristics such as age, gender, comorbidities and other personal and clinical variables can affect treatment outcomes in psychotherapy for people with borderline personality disorder. Identifying such variables is key in guiding the clinical treatment choice so it matches the individual optimally and exerts the best possible effect.

Method: We used individual participant data (IPD) meta-analyses to investigate predictors of treatment effects on specialized psychotherapies compared to treatment as usual, other active treatments or waitlist/no intervention in people with borderline personality disorder. The IPD-BPD project investigates the three outcome sets: borderline symptom severity and interpersonal functioning, self-harm and suicide related outcomes, and quality of life and psychosocial functioning. We searched for randomized controlled trials in 21 databases and trial registries and included trials, extracted data and assessed risk of bias following Cochrane standards. Authors of all included trials were contacted with data requests and invitations to participate in the project. Data was checked and harmonized into one large IPD database, and the one-step analysis approach was applied.

Results: Preliminary results on predicting variables of treatment effects in the project outcomes will be presented.

  1. Storebø OJ, Ribeiro JP, Kongerslev MT, Stoffers-Winterling J, Sedoc Jørgensen M, Lieb K, et al. Individual participant data systematic reviews with meta-analyses of psychotherapies for borderline personality disorder. BMJ Open [Internet]. 2021 Jan 21;11(6):e047416. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34155077
  2. Storebø OJ, Stoffers-Winterling JM, Völlm BA, Kongerslev MT, Mattivi JT, Jørgensen MS, et al. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020;(5).
  3. Stoffers-Winterling JM, Storebø OJ, Kongerslev MT, Faltinsen E, Todorovac A, Sedoc Jørgensen M, et al. Psychotherapies for borderline personality disorder: a focused systematic review and meta-analysis. Br J Psychiatry [Internet]. 2022 Jan 28;1–15. Available from: https://www.cambridge.org/core/product/identifier/S000712502100204X/type/journal_article
  4. Debray TPA, Moons KGM, van Valkenhoef G, Efthimiou O, Hummel N, Groenwold RHH, et al. Get real in individual participant data (IPD) meta‐analysis: a review of the methodology. Res Synth Methods. 015;6(4):293–309.
  5. Riley RD, Stewart LA, Tierney JF. Individual Participant Data Meta‐Analysis for Healthcare Research. In: Individual Participant Data Meta‐Analysis. John Wiley & Sons; 2021.