Patients with borderline personality disorder frequently drop out prematurely from psychotherapy. This study examined factors related to treatment attrition in 180 patients enrolled in a randomized controlled trial comparing 1 year of Dialectical Behavior Therapy (DBT) to General Psychiatric Management (GPM). Completers and dropouts were compared on a range of variables, including demographics, Axis I and Axis II disorders, anger and impulsivity, therapeutic alliance, and treatment condition. The participants were on average 30.36 years old and 86% were female. Regression analyses revealed that individuals who dropped out had higher levels of anger (p = .01), greater Axis I comorbidity (p = .03), poorer therapeutic alliance (p = .003), and a higher number of lifetime suicide attempts (p = .05). An interaction was also found between Axis I comorbidity and treatment condition, with significantly lower rates of dropout seen in individuals with high Axis I comorbidity who were assigned to GPM compared to those assigned to DBT (p < .001).
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