Factors predicting early dropout from dialectical behaviour therapy in individuals with borderline personality disorder.

Background: Dialectical behaviour therapy skills training (DBT-ST) has proven effective to treat individuals with borderline personality disorder (BPD). However, therapy still faces the problem of early dropout. The aim of the present study is to examine which factors are associated with early dropout from DBT-ST in a sample of subjects with BPD.

Method: 118 subjects with BPD diagnosis were included in the study. Apart from socio-demographic and clinical variables, childhood trauma history, personality dimensions, and comorbidities with other psychiatric disorders were collected. Differences in regards to the aforementioned variables were compared between individuals who dropped out prematurely from therapy and those who finalized it.

Results: Significant differences between groups regarding socio-demographic and clinical variables, including childhood trauma history and comorbid personality disorders, were not found. Both groups differed significantly in regards to trait impulsiveness and in comorbidity with Eating Disorders (ED) and Cocaine Use Disorder (CUD). The regression analyses showed that ED and CUD significantly predicted drop-out (p=0.011 and p=0.031 respectively), while scores in trait impulsivity showed a tendency towards signification (p=0.063).

Conclusions: Comorbidities between BPD and axis I disorders (i.e., ED and CUD) should be taken into account when referring patients to DBT-ST.