Can CT cure borderline personality disorder?

It might be a bit of an exaggeration to talk about "cure," but a study by Greg Brown and his colleagues which will be appearing in the Journal of Personality Disorders produced very interesting results. In this open clinical trial, 32 subjects with Borderline Personality Disorder accompanied by suicidality or self-mutilation recieved one year of weekly Cognitive Therapy for BPD (Layden et al, 1993). The year of treatment resulted in significant decreases in suicidality, reports of self-mutilation, hopelessness, depression, number of BPD symptoms, and dysfunctional beliefs. These improvements were maintained six months following termination of treatment.

At the close of treatment, independent diagnosticians found that only 48% (14 of 29) of the subjects still met full DSM criteria for BPD. At the six-month follow-up, only 16% (4 of 24) met DSM criteria for BPD. Apparently, improvement continued following termination of treatment.

If only 16% still meet DSM criteria, some might argue that CT has "cured" BPD. However, it is important to note that a person who no longer meets DSM criteria for BPD could still have some significant problems. It would be premature to talk about "cure" but these results are very encouraging.

This study was an open clinical trial, there was no control group and there was no random assignment. The next step will be to conduct randomized, controlled outcome studies.

Brown, G. K., Newman, C. F., Charlesworth, C. E., Crits-Cristoph, P. & Beck, A. T. (in press). An open clinical trial of cognitive therapy for borderline personality disorder. Journal of Personality Disorders

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