Evaluation of Cognitive-Analytic Therapy (CAT) outcome in patients with Borderline Personality Disorder

Abstract

Background CAT is a type of brief psychotherapy, which integrates in theory and practice concepts and methods from cognitive, psychoanalytic, behavioral and other approaches. There are studies showing the effectiveness of CAT in various psychiatric disorders. The present study aims to investigate the outcome of CAT in patients with borderline personality disorder (BPD) with and without an additional axis-I diagnosis according to DSM-IV criteria. Materials and methods The sample of the study consisted of 91 patients, who attended the Community Mental Health Center of N/W district of Thessaloniki over a period of 4 years (2002- 2005), received a diagnosis of BPD or personality disorder NOS with predominant borderline traits according to DSM-IV criteria and for whom it has been decided to be treated with CAT. The MMPI, the EPQ and the Post-therapy Questionnaire (PtQ) were used as evaluation instruments on the two follow ups, 2 months and 1 year after therapy termination. Results On the 2-month follow up, 57 patients, who attended the follow-up, showed a statistically significant improvement on almost all the clinical scales, on the sum of the clinical scales and on some of the research scales of the MMPI, as well as on some scales of the EPQ, compared to the intake. On the 1-year follow-up the patients (N=40) maintained the achieved improvement. Patients with BPD only (N=21), showed the same improvement on follow-up, as the patients with BPD and an additional axis-I diagnosis. Conclusions CAT is an effective brief psychotherapeutic technique for patients with BPD with and without a comorbid diagnosis (axis-I) of a clinical syndrome. The beneficial effect is sustained at least for 1 year after therapy termination. Further investigation is necessary to validate the above findings in more distant follow-ups.