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The BOOTS trial compared dialectical behaviour therapy (DBT) with schema therapy (ST) in 204 adults with borderline personality disorder across nine outpatient centres in the Netherlands. Participants received treatment over 2 years, with outcomes assessed up to 3 years. Both groups demonstrated substantial reductions in borderline personality disorder severity, but the intention-to-treat analysis found no statistically significant difference between treatments (P = .27; r = 0.09). At 36 months, the estimated mean difference in BPDSI-5 scores was −1.09 (Cohen’s d = 0.15; 95% CI, −0.17 to 0.47). Dropout rates were also not significantly different between DBT and ST. The findings suggest that both therapies can produce substantial long-term improvements, without evidence that either approach is superior for outpatients with borderline personality disorder.
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The BOOTS trial compared dialectical behaviour therapy (DBT) with schema therapy (ST) in 204 adults with borderline personality disorder across nine outpatient centres in the Netherlands. Participants received treatment over 2 years, with outcomes assessed up to 3 years. Both groups demonstrated substantial reductions in borderline personality disorder severity, but the intention-to-treat analysis found no statistically significant difference between treatments (P = .27; r = 0.09). At 36 months, the estimated mean difference in BPDSI-5 scores was −1.09 (Cohen’s d = 0.15; 95% CI, −0.17 to 0.47). Dropout rates were also not significantly different between DBT and ST. The findings suggest that both therapies can produce substantial long-term improvements, without evidence that either approach is superior for outpatients with borderline personality disorder.
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