Further Considerations on Early Intervention for Borderline Personality Disorder

To the Editor Chanen and colleagues report on the Monitoring Outcomes of Borderline Personality Disorder (BPD) in Youth (MOBY) randomized clinical trial. The study found early intervention (ie, weekly cognitive analytic therapy and case management) was not superior to other treatment arms offering case management and befriending (involving conversations with trainee psychologists about neutral topics such as sport and music), which was used as a psychotherapy control condition.

Chanen et al claim a true treatment effect for the MOBY trial because improvement across all treatment arms was superior to treatment as usual in Australian primary care according to the findings from a separate study. On this basis, they conclude that young people with BPD respond to case management and befriending and do not require specialist psychotherapy...