Dialectical Behaviour Therapy for Eating Disorders With Comorbid Borderline Personality Disorder: A Systematic Review...

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioural Science

Background:

• Comorbidity of Borderline Personality Disorder (BPD) and Eating Disorders (EDs) is common.
• This comorbidity is associated with increased clinical severity and emotion dysregulation.
• Dialectical Behaviour Therapy (DBT) is a potential intervention for these complex cases.

Purpose of the Study:

• To systematically review and synthesize evidence on the effectiveness of DBT for improving ED outcomes in individuals with comorbid BPD and EDs.
• To evaluate the impact of DBT on eating disorder symptom severity, maladaptive eating behaviors, and self-harm.
• To identify limitations and future research directions in this clinical area.

Main Methods:

• A systematic literature search was conducted across major databases (Wiley, Web of Science, SpringerLink, Scopus) following PRISMA 2020 guidelines.
• Eight studies meeting inclusion criteria, which examined DBT interventions in comorbid BPD and ED samples with quantitative outcomes, were included.
• Risk of bias was assessed using Joanna Briggs Institute (JBI) checklists, and a narrative synthesis was performed.

Main Results:

• DBT interventions were associated with reductions in ED symptom severity, binge eating, purging, and self-harm.
• Baseline BPD symptom severity did not consistently predict poorer outcomes; some cases showed greater early improvement.
• Significant heterogeneity in study design, sample characteristics, and outcome measures was noted, with variable methodological quality.

Conclusions:

• DBT is a clinically relevant and promising transdiagnostic intervention for individuals with comorbid BPD and EDs.
• The current evidence base is limited by methodological constraints, necessitating well-designed randomized controlled trials.
• Findings support the use of DBT in complex comorbid populations, emphasizing the need for mechanism-focused research.