Dialectical behavior therapy in Chinese suicidal patients with borderline personality disorder: A pilot randomized controlled trial

Abstract

We conducted a single-blind, randomized controlled trial to examine the implementation of dialectical behavior therapy (DBT) in Chinese patients with borderline personality disorder (BPD) with at least two suicidal or non-suicidal self-injurious episodes. Of the 150 BPD patients referred and screened, 60 participated in the trial and were randomly assigned to 1 year of either DBT or psychotherapy delivered by community experts in suicide prevention. Reductions in self-injurious behaviors, medical utilizations due to suicidal ideations or suicidal attempts, borderline symptoms, and psychological distress were noted in both groups. However, no between-group differences were noted at the end of treatments (Table 1). Our results suggest that BPD patients with suicidal attempts benefited equally from DBT and treatment delivered by suicide prevention experts in Taiwan. Reasons for the lack of significant between-group differences may be that although we requested patients' psychiatrists provide only general psychiatric pharmacotherapy or case management; it might be possible that DBT elements may have been infused in the treatment course. Cultural factors may include that Chinese patients tend to have negative views about sharing their own opinions in group therapy (Hansher, 2015), or to express their emotions (Chiu et al., 2019; Mingzhao et al., 1992), because these behaviors might be judged as being “too emotional,” and participants may therefore readily