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Updated: Oct 21, 2025

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Intensive Dialectical Behavior Treatment for Individuals With Borderline Personality Disorder With and Without
Frank D Buono1, Kaitlyn Larkin1, David Rowe2
1Yale School of Medicine, New Haven, CT, United States.
Abstract:
Treatment of borderline personality disorder (BPD) with comorbid substance use disorder can be challenging due to symptom overlap and limited assessment methods. Preliminary evidence has shown promising effectiveness of dialectical behavioral therapy (DBT) for BPD with comorbid substance use disorders. The current study compared the benefits of a 28-day transitional DBT treatment program for individuals with BPD with and without substance use disorders through evaluating the changes in coping skills, generalized anxiety, and depression symptom scales at admission and discharge. A total of 76 patients were split into two groups: Group 1 consisted of individuals with BPD without substance use disorders (n = 41), and Group 2 involved individuals with BPD and a substance use disorder (SUD) (n = 35). A univariate general linear model showed significant differences between the two groups in improvement of coping skills and depressive symptoms. After a 28-day transitional DBT treatment program there were significant decreases from severe to moderate depression scores in both groups. Our findings support the effectiveness of DBT treatment in patients with comorbid BPD and SUD.
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