Evidence map›Paper›PMID 38986457›Full record

Trial reportPsychotherapy and psychosomatics2024

The Effectiveness of Dialectical Behavior Therapy Compared to Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial.

Nele Assmann, Anja Schaich, Arnoud Arntz, Till Wagner, Philipp Herzog, Daniel Alvarez-Fischer, Valerija Sipos, Kamila Jauch-Chara, Jan Philipp Klein, Michael Hüppe and 2 more

Erratum issuedAbstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Psychotherapy and psychosomatics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Review
  7. Article
  8. Psychometric Evaluation of the Borderline Personality Disorder Checklist.International journal of methods in psychiatric research · 2025
    Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Nele AssmannDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Anja SchaichDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Arnoud ArntzDepartment of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
Till WagnerDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Philipp HerzogDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Daniel Alvarez-FischerDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Valerija SiposDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Kamila Jauch-CharaDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Jan Philipp KleinDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Michael HüppeDepartment of Anaesthesiology, University of Lübeck, Lübeck, Germany.
Ulrich SchweigerDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.
Eva FassbinderDepartment of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn the treatment of borderline personality disorder (BPD), there is empirical support for both dialectical behavior therapy (DBT) and schema therapy (ST); these treatments have never been compared directly. This study examines whether either of them is more effective than the other in treating patients with BPD.

methodsIn this randomized, parallel-group, rater-blind clinical trial, outpatients aged between 18 and 65 years with a primary diagnosis of BPD were recruited in a tertiary outpatient treatment center (Lübeck, Germany). Participants were randomized to DBT or ST with one individual and one group session per week over 1.5 years. The primary outcome was the BPD symptom severity assessed with the mean score of the Borderline Personality Disorder Severity Index at 1-year naturalistic follow-up.

resultsBetween November 26, 2014, and December 14, 2018, we enrolled 164 patients (mean age = 33.7 [SD = 10.61] years). Of these, 81 (49.4%) were treated with ST and 83 (50.6%) with DBT, overall, 130 (79.3%) were female. Intention-to-treat analysis with generalized linear mixed models did not show a significant difference at 1-year naturalistic follow-up between DBT and ST for the BPDSI total score (mean difference 3.32 [95% CI: -0.58-7.22], p = 0.094, d = -24 [-0.69; 0.20]) with lower scores for DBT. Pre-to-follow-up effect sizes were large in both groups (DBT: d = 2.45 [1.88-3.02], ST: d = 1.78 [1.26-2.29]).

conclusionPatients in both treatment groups showed substantial improvements indicating that even severely affected patients with BPD and various comorbid disorders can be treated successfully with DBT and ST. An additional non-inferiority trial is needed to show if both treatments are equally effective. The trial was retrospectively registered on the German Clinical Trials Register, DRKS00011534 without protocol changes.

Indexed as

Borderline Personality DisorderDialectical Behavior TherapyAdolescentAdultBehavior TherapyFemaleGermanyHumansMaleMiddle AgedTreatment OutcomeYoung AdultBorderline personality disorderEffectivenessPsychotherapy researchRandomized clinical trialsTreatment outcome

Identifiers

PMID38986457
PMCPMC11332312

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.