"Skills for pills": The dialectical-behavioural therapy skills training reduces polypharmacy in borderline personality disorder

Altres ajuts: acords transformatius de la UABObjective: Polypharmacy and overprescription of off-label medications are common in patients with borderline personality disorder (BPD). The aim of the present naturalistic study was to explore whether the skills training module of dialectical-behavioral therapy (DBT) can reduce polypharmacy in these patients in routine clinical practice. Methods: Retrospective, observational study of 377 patients with a primary diagnosis of BPD consecutively admitted to the BPD outpatient unit from 2010 through 2020. All of the patients were invited to participate in the DBT skills training module (DBT-ST). DBT-ST participants (n=182) were compared to a control group comprised of patients who did not participate (n=195). Pre-post intervention changes in the medication load and use of antidepressants, benzodiazepines, mood stabilizers and antipsychotics were evaluated. Results: At baseline, most patients (84.4%) were taking at least one medication and 46.9% were on polypharmacy. Compared to controls, patients in the DBT-ST group presented a significant reduction in the number of medications (2.67 to 1.95 vs. 2.16 to 2.19; p<0.001), medication load (4.25 to 3.05 vs. 3.45 to 3.48; p<0.001) and in the use of benzodiazepines (54.4% to 27.5% vs. 40% to 40.5%; p<0.001), mood stabilizers (43.4% to 33% vs. 36.4% to 39.5%; p<0.001) and antipsychotics (36.3% to 29.1% vs. 34.4% to 36.9; p