Effect of group psychotherapy on the annual incidence of self-harm and suicide attempts in borderline personality disorder: A pilot study

Abstract

Introduction Borderline personality disorder (BPD) has been characterized by mood instability, impulsive behavior and eventual dissociative and psychotic symptoms. Around 70% of patients present repeated self-injury behavior which is associated with high risk of completed suicide. Objectives To investigate the effect of group psychotherapy on the annual incidence of self-harm behavior and suicide attempts in BPD. Methods We carried out a retrospective longitudinal study by selecting BPD patients who received group psychotherapy during 2016. Systems Training for Emotional Predictability and Problem Solving (STEPPS) or Mentalization-Based Treatment (MBT) psychotherapies were applied. Patients without any self-harm/suicidal attempt before the intervention, those with comorbid diagnosis and those who did not engage at least half of total sessions were excluded for final analyses. Number of self-harm events, suicide attempts and other clinical events were recorded and compared one-year before and one-year post-intervention. SPSS software version 21.0 (IBM) was used for statistical analyses. Nonparametric tests and Survival tests were performed. Results Eight women out of 35 fulfilled our inclusion criteria. After group psychotherapy, a significant reduction in the number of self-harm events and suicidal attempts was found (mean 1.9+/-1.4 vs 0.5+/-1.1; p=0.042). Survival tests revealed significant differences in the occurrence of suicidal attempts. We did not find significant differences in the other clinical events. Conclusions Our results show a clear effectiveness of group psychotherapy in reducing self-harm events and/or suicidal attempts in BPD patients. If these findings are confirmed in future studies including larger samples, group psychotherapy could be indicated for diminishing suicide risks in BPD. Disclosure No significant relationships.

Keywords

• Borderline personality disorder
• psychotherapy
• Suicide
• Self-harm behavior