Purpose: Individuals with eating disorders (ED) and comorbid borderline personality disorder (BPD) may benefit from therapies focusing on emotion regulation, such as dialectical behavioral therapy (DBT). The aim of the study was to evaluate the effectiveness of one-year standard DΒΤ enhanced with cognitive-behavioral therapy (CBT) strategies for patients suffering from ED and BPD.
Methods: Seventy-two BPD and ED (anorexia and bulimia nervosa) participants were recruited from the eating disorders unit of the 1st Psychiatric Department of National and Kapodistrian University of Athens. All participants completed one year of standard DBT. ED-related behaviors were added to the treatment plan according to the DBT targeting hierarchy. Individual therapy and skills training group sessions were adapted to incorporate CBT strategies for nutritional and weight restoration. BPD and ED symptomatology were measured at the beginning and at the end of one year of treatment.
Results: The major finding of the study was the significant improvement of patients in all the outcome measurements after one year of treatment. The study's second finding was that the severity of BPD symptomatology was significantly related to the severity of ED symptomatology. It was also shown that improvement of the patients coping skills was correlated with the reduction of ED and BPD symptomatology.
Conclusions: These results support previous studies on the effectiveness of DBT for comorbid BPD and EDs. Despite the promising results, randomized controlled trials are needed to establish the efficacy of DBT for BPD and ED patients.
Level of evidence: Level IV: Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.
Keywords: Anorexia nervosa; Borderline personality disorder; Bulimia nervosa; Dialectical behavioral therapy; Eating disorders.
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