OBJECTIVE: At present, the most frequently investigated psychosocial 
intervention for borderline personality disorder (BPD) is dialectical behavior 
therapy (DBT). We conducted a meta-analysis to examine the efficacy and 
long-term effectiveness of DBT.
METHOD: Systematic bibliographic research was undertaken to find relevant 
literature from online databases (PubMed, PsycINFO, PsychSpider, Medline). We 
excluded studies in which patients with diagnoses other than BPD were treated, 
the treatment did not comprise all components specified in the DBT manual or in 
the suggestions for inpatient DBT programs, patients failed to be diagnosed 
according to the Diagnostic and Statistical Manual of Mental Disorders, and the 
intervention group comprised fewer than 10 patients. Using a mixed-effect 
hierarchical modeling approach, we calculated global effect sizes and effect 
sizes for suicidal and self-injurious behaviors.
RESULTS: Calculations of postintervention global effect sizes were based on 16 
studies. Of these, 8 were randomized controlled trials (RCTs), and 8 were 
neither randomized nor controlled (nRCT). The dropout rate was 27.3% pre- to 
posttreatment. A moderate global effect and a moderate effect size for suicidal 
and self-injurious behaviors were found, when including a moderator for RCTs 
with borderline-specific treatments. There was no evidence for the influence of 
other moderators (e.g., quality of studies, setting, duration of intervention). 
A small impairment was shown from posttreatment to follow-up, including 5 RCTs 
only.
CONCLUSIONS: Future research should compare DBT with other active 
borderline-specific treatments that have also demonstrated their efficacy using 
several long-term follow-up assessment points.