Effects of Mentalization-based Therapy in interpersonal relationships and social adjustment in Borderline Personality Disorder - A systematic review.

Abstract

Background: Borderline Personality Disorder (BPD) is a mental health condition characterized by impulsivity, affective and self-image instability and interpersonal dysfunction. The lack of mentalization seen in these individuals is a key factor for the interpersonal dysfunction enhancing other symptoms. Mentalization-based therapy (MBT) focuses on improving this capacity and, therefore, helps improve interpersonal relationships and social adjustment in individuals with BPD. Objectives: This systematic review aims to evaluate the effects of MBT on interpersonal relationships and social adjustment and when possible, if the improvement was better than with other therapies. Methods: A systematic search was conducted across five databases (PubMed, Scopus, Web of Science, ClinicalTrials, and Cochrane Library) between November 2024 and January 2025. Randomized controlled trials (RCTs), cohort studies, and naturalistic comparisons that assessed MBT's effects on interpersonal relationships and social adjustment in BPD patients were included. Studies were critically appraised for quality and risk of bias. Results: Ten studies were included in the review. The majority of studies showed that MBT is associated with significant improvements in interpersonal relationships and social adjustment as measured by various scales. Two RCTs demonstrated the superiority of MBT over two other therapeutic approaches, the psychodynamic treatment program and structured clinical management (SCM). Conclusion: MBT positively affects interpersonal relationships and social adjustment in BPD patients, though it is not consistently superior to alternative treatments. Further research is needed to explore long-term effects, cost-effectiveness, and individualized treatment adaptations to optimize therapeutic outcomes.