The efficacy of schema therapy for personality disorders: a systematic review and meta-analysis

Nord J Psychiatry. 2023 Oct;77(7):641-650. doi: 10.1080/08039488.2023.2228304. Epub 2023 Jul 4.

Abstract

Objective: Personality disorders (PDs) are prevalent and associated with functional impairment and psychological disability. Studies suggest that schema therapy (ST) may be an effective treatment for PDs. This review aimed to evaluate the efficacy of ST in treating PDs.

Method: We conducted a comprehensive literature search using PubMed, Embase, Web of Science, CENTRAL, PsycInfo, and Ovid Medline. We identified eight randomized controlled trials (587 participants) and seven single-group trials (163 participants).

Results: Meta-analyses revealed that ST had a moderate effect size (g = 0.359) compared to control conditions in reducing symptoms of PDs. Subgroup analysis indicated that the effect of ST on different types of PDs varied slightly, and that group ST (g = 0.859) was more effective than individual ST (g = 0.163) in treating PDs. Secondary outcome analysis revealed a moderate effect size (g = 0.256) for ST compared to control conditions in improving quality of life, and ST was found to reduce early maladaptive schema (g = 0.590). Single-group trials analysis showed that ST had a positive effect on PDs (OR = 0.241).

Conclusion: ST appears to be an effective treatment for PDs, as it reduces symptoms and improves quality of life. This review provides support for the use of ST in the treatment of PDs.

Keywords: Personality disorders; meta-analysis; schema therapy; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Humans
  • Personality Disorders / therapy
  • Psychotherapy
  • Psychotherapy, Group*
  • Quality of Life
  • Schema Therapy*