Community Mental Health Journal

, Volume 52, Issue 2, pp 212–215 | Cite as

Psychotherapy of Borderline Personality Disorder: Can the Supply Meet the Demand? A German Nationwide Survey in DBT Inpatient and Day Clinic Treatment Facilities

  • Christoph Richter
  • Bruno Steinacher
  • Anna zum Eschenhoff
  • Felix Bermpohl
Original Paper


The present study aimed to assess (1) the amount of inpatient and day clinic DBT treatment places for patients with borderline personality disorder and (2) the relationship between supply and demand in a given study region. Survey of inpatient and day clinic facilities in the German DBT network. 42 inpatient units and day clinics responded, representing 75 % of the DBT network members contacted. These institutions offer 527 DBT treatment places and treat about 2310 patients per year. The mean waiting period prior to treatment was 14.3 weeks. 700 DBT inpatient or day clinic places exist in Germany in 2011. 3000 patients receive DBT inpatient or day clinic treatment per year. This approximates a ratio of 820 borderline patients for one existing DBT inpatient or day clinic place in Germany. The long waiting time reflects the great demand for this treatment and could be interpreted as an imbalance between supply and demand.


Borderline personality disorder Inpatient hospital Day hospital Mental health care Psychotherapy DBT 


  1. Bateman, A., & Fonagy, P. (1999). Effectiveness of partial hospitalization in the treatment of borderline personality disorder: A randomized controlled trial. American Journal of Psychiatry, 156(10), 1563–1569.CrossRefPubMedGoogle Scholar
  2. Bateman, A., & Fonagy, P. (2001). Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: An 18-month follow-up. American Journal of Psychiatry, 158(1), 36–42.CrossRefPubMedGoogle Scholar
  3. Bateman, A., & Fonagy, P. (2010). Mentalization based treatment for borderline personality disorder. World Psychiatry, 9(1), 11–15.PubMedCentralCrossRefPubMedGoogle Scholar
  4. Bohus, M. (2007). Zur Versorgungssituation von Borderline-Patienten in Deutschland. Persönlichkeitsstörungen Theorie Therapie, 11, 149–153.Google Scholar
  5. Bohus, M., & Kröger, C. (2011). Psychopathologie und Psychotherapie der Borderline-Persönlichkeitsstörung: Zum gegenwärtigen Stand der Forschung. Der Nervenarzt, 82(1), 16–24.CrossRefPubMedGoogle Scholar
  6. Coid, J., Yang, M., Tyrer, P., Roberts, A., & Ullrich, S. (2006). Prevalence and correlates of personality disorder in Great Britain. British Journal of Psychiatry, 188, 423–431.CrossRefPubMedGoogle Scholar
  7. Dachverband, D. B. T. (2011). Behandlungsangebote in Deutschland, Österreich und in der Schweiz.
  8. Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C., van Asselt, T., et al. (2006). Outpatient psychotherapy for borderline personality disorder: Randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of General Psychiatry, 63(6), 649–658.CrossRefPubMedGoogle Scholar
  9. Jobst, A., Hörtz, S., Birkhofer, A., Martius, P., & Rentrop, M. (2010). Einstellung von Psychotherapeuten gegenüber der Behandlungs von Patienten mit Borderline-Persönlichkeitsstörung. Psychotherapie, Psychosomatik, Medizinische Psychologie, 60(30/4), 126–131.CrossRefPubMedGoogle Scholar
  10. Kernberg, O. F. (1981). Treatment technics in borderline personality disorders. Psyche (Stuttg), 35(6), 497–526.Google Scholar
  11. Kernberg, O. F., Yeomans, F. E., Clarkin, J. F., & Levy, K. N. (2008). Transference focused psychotherapy: Overview and update. International Journal of Psychoanalysis, 89(3), 601–620.CrossRefPubMedGoogle Scholar
  12. Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. Lancet, 364(9432), 453–461.CrossRefPubMedGoogle Scholar
  13. Linehan, M. M. (1993). Dialectical behavior therapy for treatment of borderline personality disorder: Implications for the treatment of substance abuse. NIDA Research Monograph, 137, 201–216.PubMedGoogle Scholar
  14. Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48(12), 1060–1064.CrossRefPubMedGoogle Scholar
  15. Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., et al. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757–766.CrossRefPubMedGoogle Scholar
  16. Oldham, J. M. (2006). Borderline personality disorder and suicidality. American Journal of Psychiatry, 163(1), 20–26.CrossRefPubMedGoogle Scholar
  17. Richter, C., Heinemann, B., Kehn, M., & Steinacher, B. (2013). Effectiveness of Dialectical Behavior Therapy (DBT) in an outpatient clinic for borderline personality disorders—Impact of medication use and treatment costs. Psychiatrische Praxis, 41(3), 148–152.CrossRefPubMedGoogle Scholar
  18. Samuels, J., Eaton, W. W., Bienvenu, O. J, 3rd, Brown, C. H., Costa, P. T, Jr, & Nestadt, G. (2002). Prevalence and correlates of personality disorders in a community sample. British Journal of Psychiatry, 180, 536–542.CrossRefPubMedGoogle Scholar
  19. Torgersen, S., Kringlen, E., & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58(6), 590–596.CrossRefPubMedGoogle Scholar
  20. van Asselt, A. D., Dirksen, C. D., Arntz, A., & Severens, J. L. (2007). The cost of borderline personality disorder: Societal cost of illness in BPD-patients. European Psychiatry, 22(6), 354–361.CrossRefPubMedGoogle Scholar
  21. Wagner, T., Roepke, S., Marschall, P., Stiglmayr, C., Renneberg, B., Gieb, D., et al. (2014). Societal cost-of-illness in patients with borderline personality disorder one year before, during and after dialectical behavior therapy in routine outpatient care. Behaviour Research and Therapy, 61(10), 12–22.CrossRefPubMedGoogle Scholar
  22. Zanarini, M. C., Frankenburg, F. R., Dubo, E. D., Sickel, A. E., Trikha, A., Levin, A., et al. (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry, 155(12), 1733–1739.CrossRefPubMedGoogle Scholar
  23. Zanarini, M. C., Frankenburg, F. R., Hennen, J., Reich, D. B., & Silk, K. R. (2006). Prediction of the 10-year course of borderline personality disorder. American Journal of Psychiatry, 163(5), 827–832.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Christoph Richter
    • 1
    • 2
  • Bruno Steinacher
    • 2
  • Anna zum Eschenhoff
    • 3
  • Felix Bermpohl
    • 1
  1. 1.Department of Psychiatry and PsychotherapyCharité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of Psychiatry and Psychotherapy, Vivantes GmbHWenckebach-HospitalBerlinGermany
  3. 3.Clinical Psychology and PsychotherapyFreie UniversitätBerlinGermany

Personalised recommendations