Effectiveness of psychotherapies in co-occurring substance-related disorder and borderline personality disorder: a systematic review

Although Borderline Personality Disorder (BPD) prevalence rates are estimated around 2%, in drug-dependent population it could reach up to 60%. This subgroup of patients has higher substance abuse, more relapses, poorer adherence to treatment, more self-harm and greater comorbidity. A systematic review was conducted to evaluate the effectiveness of psychotherapies in co-occurring substance-related disorder (SUD) and BPD. PubMed, PsycINFO and Cochrane Library databases were used for this purpose. Finally, 16 studies were included (randomized clincial trial and quasi- experimental designs. The effectiveness of eight psychotherapies was evaluated: Dialectical Behavioral Therapy (DBT), Dual Focus Schema Therapy (DFST), Dynamic Deconstructive Psychotherapy (DDP), Integrative BPD- oriented Adolescent Family Therapy(I-BAFT), Acceptance and Commitment Therapy (ACT), Good Psychiatric Management (GPM), Mentalization-Based Therapy (MBT) and System Training for Emotional Predictability and Problem Solving(STEPPS). Of these, DBT and DDP are the most supported by literature. Other interventions provide encouraging results but need to be evaluated by further research. It can be affirmed that there are effective interventions that should move professionals away from therapeutic nihilism that often prevails in treating dual patients.