Summary of findings 2. Psychotherapy versus waiting list or no treatment.
| Psychotherapy versus waiting list or no treatment | ||||||
|
Patient or population: borderline personality disorder Settings: inpatient and outpatient Intervention: psychotherapy Comparison: waiting list or no treatment | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) |
Number of participants (RCTs) |
Quality of the evidence (GRADE) |
Comments | |
| Assumed risk | Corresponding risk | |||||
| Waiting list or no treatment | Psychotherapy | |||||
|
BPD symptom severity Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment |
‐ | The mean score in the intervention groups was 0.49 SD lower (0.93 lower to 0.05 lower) | ‐ | 161 (3 RCTs) |
⊕⊕⊝⊝ Lowa,b | An SMD of 0.49 represents a moderate effect. |
|
Self‐harm Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment |
‐ | The mean score in the intervention groups was0.17 SD lower (0.52 lower to 0.18 higher) | ‐ | 128 (2 RCTs) |
⊕⊕⊝⊝ Lowa,b | An SMD of 0.17 represents a small effect. |
|
Suicide‐related outcomes Measured by: self‐rated Timing of outcome assessment: end of treatment |
‐ | The mean score in the intervention groups was 5.62 SD lower (16.39 lower to 5.16 higher) | ‐ | 108 (2 RCTs) |
⊕⊝⊝⊝ Verylowa,b,c |
An SMD of 5.62 represents a large effect. |
|
Psychosocial functioning Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment |
‐ | The mean score in the intervention groups was 0.56 SD lower (1.01 lower to 0.11 lower) | ‐ | 219 (5 RCTs) |
⊕⊕⊝⊝ Lowa,b | An SMD of 0.56 represents a moderate effect. |
|
Depression Measured by: clinicians and self‐rated Timing of outcome assessment: end of treatment |
‐ | The mean score in the intervention groups was 1.28 SD lower (2.21 lower to 0.34 lower) | ‐ | 239 (6 RCTs) |
⊕⊕⊝⊝ Lowa,b | An effect size of 1.28 represents a large effect. |
|
Attrition Timing of outcome assessment: end of treatment |
81 per 1000 | 147 per 1000 (95% CI 118 fewer to 74 higher) | RR 0.55 (95% CI 0.20 to 1.50) | 144 (3 RCTs) |
⊕⊝⊝⊝ Verylowa,b,c | ‐ |
| Adverse effects (not measured | See comments | See comments | ‐ | ‐ | ‐ | No studies were found that assessed this outcome |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RCTs: Randomised controlled trials; RR: Risk ratio; SMD: Standardized mean difference | ||||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Very low quality: we are very uncertain about the estimate | ||||||
aWe downgraded the quality of this evidence by one level due to risk of bias. bWe downgraded the quality of this evidence by one level due to imprecision (there was a wide CI). cWe downgraded the quality of this evidence by one level due to inconsistency.