Randomized Controlled Trial of Web-Based Psychoeducation for Women With Borderline Personality Disorder

Objective: To determine if internet-based psychoeducation for borderline personality disorder is effective in reducing symptom severity and improving psychosocial functioning.

Methods: Eighty women who met DSM-IV criteria for borderline personality disorder were randomly assigned either to the internet-based psychoeducation treatment group (n = 40) or to the internet-based control group with no psychoeducation (n = 40). Recruitment was conducted from July 2013 to March 2015. Subjects participated in 15 assessment periods that were divided into an acute phase (weeks 1–12) and a maintenance phase (months 6, 9, and 12). Main outcomes were assessed using the Zanarini Rating Scale for Borderline Personality Disorder.

Results: In the acute phase, women in the treatment group were found to have a significant decline in their scores on all 10 outcomes studied, while women in the control group had a significant decline on 7 of these outcomes. Two between-group differences were found to be significant—those in the treatment group reported a significantly greater decline in their impulsivity (z = 1.98, P = .048) and a significantly greater increase in their psychosocial functioning (z = 1.97, P = .049) than those in the control group. In the maintenance phase, those in the treatment group were found to have a significant decline in their scores on 9 of the 10 outcomes studied, while those in the control group had a significant decline in 3 of these outcomes. In terms of between-group differences, those in the treatment group reported a significantly greater decline in all 5 studied areas of borderline psychopathology: affective symptoms (z = 2.31, P = .021), cognitive symptoms (z = 3.20, P = .001), impulsivity (z = 2.44, P = .015), interpersonal difficulties (z = 2.15, P = .032), and overall borderline personality disorder symptoms (z = 2.11, P = .035).

Conclusions: Taken together, these results suggest that internet-based psychoeducation is an effective form of early treatment for reducing the symptom severity of borderline personality disorder for periods up to 1 year.

Trial Registration: ClinicalTrials.gov identifier: NCT01719731

J Clin Psychiatry 2018;79(3):16m11153

https://doi.org/10.4088/JCP.16m11153