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Objective: 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-behavioural 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 patients were invited to participate in the DBT skills training module (DBT-ST). DBT-ST participants (n = 182) were compared with a control group who did not participate in DBT-ST (n = 195). Pre-post intervention changes in 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 (2.67–1.95 vs. 2.16–2.19; p < 0.001), medication load (4.25–3.05 vs. 3.45–3.48; p < 0.001), use of benzodiazepines (54.4%–27.5% vs. 40%–40.5%; p < 0.001), mood stabilizers (43.4%–33% vs. 36.4%–39.5%; p < 0.001), and antipsychotics (36.3%–29.1% vs. 34.4%–36.9%; p < 0.001). Conclusions: These findings suggest that patients with BPD can benefit from the DBT-ST module, which may reduce the medication load, particularly of sedatives. The results suggest that DBT-ST may be useful to treat overmedication in patients with BPD and could help to promote “deprescription” in clinical practice. This study was supported by Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM). The authors would like to thank Bradley Londres for professional English language editing.

In the original publication of this article [1] the funding acknowledgement for grant “PI13/00134, ERDF Funds” was missing.

Background Impulsivity is considered a core characteristic of borderline personality disorder (BPD). Previous research on the effects of mindfulness training (MT) has shown that it might modify impulsivity-related aspects of BPD. Therefore, the aim of this study was to investigate the impact of MT on various facets of impulsivity in BPD patients. Methods Subjects with BPD diagnosis (n = 64) were randomly assigned to 10 weeks of MT (n = 32) or interpersonal effectiveness skills training (IE; n = 32). All participants were assessed pre- and post-intervention with a self-reported measure of impulsivity and five behavioral neuropsychological tasks to evaluate response inhibition, tolerance for delay rewards, and time perception. Results An interaction effect of time × group was only observed for some of the behavioral paradigms used. Participants in the MT group improved their ability to delay gratification and showed changes in time perception, consistent with a decrease in impulsivity. No differences were observed between treatments in terms of trait impulsivity and response inhibition. Conclusions Mindfulness training might improve some aspects of impulsivity but not others. Further study is warranted to better determine the effects of mindfulness training on the components of impulsivity. Trial registration ClinicalTrials.gov Identifier: NCT02397031. Electronic supplementary material The online version of this article (doi:10.1186/s40479-015-0035-8) contains supplementary material, which is available to authorized users.

Background: Deficits in mindfulness-related capacities have been described in borderline personality disorder (BPD). However, little research has been conducted to explore which factors could explain these deficits. This study assesses the relationship between temperamental traits and childhood maltreatment with mindfulness in BPD. Methods: A total of 100 individuals diagnosed with BPD participated in the study. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ-SF), temperamental traits were assessed using the Zuckerman-Khulman Personality Questionnaire (ZKPQ), and mindfulness capabilities were evaluated with the Five Facet Mindfulness Questionnaire (FFMQ). Results: Hierarchical regression analyses were performed including only those CTQ-SF and ZKPQ subscales that showed simultaneous significant correlations with mindfulness facets. Results: indicated that neuroticism and sexual abuse were predictors of acting with awareness; and neuroticism, impulsiveness and sexual abuse were significant predictors of non-judging. Temperamental traits did not have a moderator effect on the relationship between childhood sexual abuse and mindfulness facets. Conclusions: These results provide preliminary evidence for the effects of temperamental traits and childhood trauma on mindfulness capabilities in BPD individuals. Further studies are needed to better clarify the impact of childhood traumatic experiences on mindfulness capabilities and to determine the causal relations between these variables.