A 26-year-old woman presents with a pattern of unstable relationships (alternating idealisation and devaluation), fear of abandonment, identity disturbance, recurrent self-cutting, and affective instability. She meets DSM-5 criteria for Borderline Personality Disorder. The psychotherapy with the strongest evidence base for BPD is:

• A Dialectical Behaviour Therapy (DBT) ✓
• B Cognitive Processing Therapy (CPT)
• C Supportive psychotherapy with medication management
• D Interpersonal Psychotherapy (IPT)

Explanation

Dialectical Behaviour Therapy (DBT), developed by Marsha Linehan, has the strongest evidence base for BPD. It combines individual therapy, group skills training (mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness), phone coaching, and therapist consultation. DBT reduces self-injurious behaviour, suicidal ideation, and psychiatric hospitalisations. Mentalization-Based Treatment (MBT) and Schema Therapy also have good evidence for BPD. CBT and IPT are effective for depression and PTSD respectively but are not first-line for BPD.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.