Crisis interventions for people with borderline personality disorder

Area of Science:

• Psychiatry
• Clinical Psychology
• Mental Health Services Research

Background:

• Individuals with borderline personality disorder (BPD) frequently experience acute crises, often involving suicidal ideation or behaviors, necessitating effective health service interventions.
• Despite the high prevalence of crises in BPD, there is a significant knowledge gap regarding the most effective management strategies for these acute situations.

Purpose of the Study:

• To systematically review the existing evidence on the effectiveness of crisis interventions for adults diagnosed with borderline personality disorder (BPD).
• To define crisis intervention as an immediate response (lasting no more than one month) aimed at ensuring safety and promoting recovery during acute distress.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (e.g., MEDLINE, PsycINFO, EMBASE) up to September 2011, including trial registries and reference lists.
• Inclusion criteria focused on randomized controlled trials (RCTs) comparing crisis interventions with usual care, no intervention, or a waiting list control for adults with BPD.
• Two independent reviewers screened studies, and expert consultation was sought for ongoing trials and unpublished data.

Main Results:

• The search identified 15 studies, but 13 were excluded due to lack of randomization, retrospective design, or intervention duration exceeding one month.
• Two ongoing RCTs meeting the inclusion criteria were identified, with a combined predicted sample size of 688 participants.
• Results from these ongoing trials were not available for inclusion in the current review but will be incorporated in future updates.

Conclusions:

• The current literature review found no randomized controlled trial (RCT)-based evidence to support the effectiveness of any specific crisis intervention for borderline personality disorder (BPD).
• There is an urgent need for high-quality, large-scale, and adequately powered RCTs to establish evidence-based practices for managing acute crises in individuals with BPD.