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. Objective(s): To investigate the effect of group psychotherapy on the annual incidence of self-harm behavior and suicide attempts in BPD. Method(s): 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, thosewith 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 postintervention. SPSS software version 21.0 (IBM) was used for statistical analyses. Nonparametric tests and Survival tests were performed. Result(s): Eight women out of 35 fulfilled our inclusion criteria. After group psychotherapy, a significant reduction in the number of selfharm 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. Conclusion(s): 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.