The outcome of psychodynamic psychotherapies with individuals diagnosed with personality disorders: a systematic review

This review aimed to explore the evidence base of psychodynamic therapy for personality disorder (PD). A systematic approach was applied to the literature search with the use of a clear inclusion/exclusion criteria and a quality assessment checklist. Nineteen studies investigating the use of psychodynamic therapy for PD were reviewed. Four randomised controlled trials (RCT) demonstrated superior results for psychodynamic therapy compared with another type of therapy, two RCTs found that cognitive-based therapies were superior and one RCT found no difference between therapies for PD. Another seven RCTs found positive results for psychodynamic therapies compared with a treatment as usual condition (n ¼ 3) or another dynamic therapy (n ¼ 4). Five non-RCTs were included with mixed findings for treating PD with psychodynamic therapy. Many of the included studies focusing on psychodynamic-based therapies with borderline personality disorder had positive outcomes, and concentrated on mentalisation-based therapy and transference-focused therapy. There were good outcomes for short- and long- term psychodynamic therapies with individuals with PD. Implications for developing services for treating PD are discussed. Research that addresses methodological issues and increases understanding of the ingredients of change in psychodynamic therapy for PD is also recommended.