Meta-Analysis and Systematic Review Assessing the Efficacy of Dialectical Behavior Therapy (DBT)

The objective was to quantitatively and qualitatively examine the efficacy of DBT (e.g., decreasing life-threatening suicidal and parasuicidal acts, attrition, and depression) explicitly with borderline personality disorder (BPD) and using conservative assumptions and criteria, across treatment providers and settings.

Five randomized controlled trials (RCTs) were identified in a systematic search that examined the efficacy of DBT in reducing suicide attempts, parasuicidal behavior, attrition during treatment, or symptoms of depression, in adult patients with BPD.

Combining effect measures for suicide and parasuicidal behavior (five studies total) revealed a net benefit in favor of DBT (pooled Hedges' g -0.622). DBT was only marginally better than treatment as usual (TAU) in reducing attrition during treatment in five RCTs (pooled risk difference -0.168). DBT was not significantly different from TAU in reducing depression symptoms in three RCTs (pooled Hedges' g -0.896).

DBT demonstrates efficacy in stabilizing and controlling self-destructive behavior and improving patient compliance.