Clinical therapeutics: Edited by Dieter Naber and Harold PincusPsychotherapy of personality disorders and concomitant substance dependenceKienast, Thorsten; Foerster, JuliaAuthor Information Department of Psychiatry and Psychotherapy, Charité – University Medical Center Berlin, Charité Campus Mitte, Berlin, Germany Correspondence to Thorsten Kienast, MD, Department of Psychiatry of the Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany Tel: +49 30 2311 2928; fax: +49 30 2311 2929; e-mail: [email protected] Current Opinion in Psychiatry: November 2008 - Volume 21 - Issue 6 - p 619-624 doi: 10.1097/YCO.0b013e32830d365c Buy Metrics Abstract Purpose of review Psychotherapy of patients with personality disorder and concomitant substance dependence requires an integrative approach. Although a number of studies have evaluated psychotherapy for one of these disorders, only few studies have described the effectiveness of treatment programs in comorbid patients. These limited findings provide a basis for the further development of treatments for personality disorder and concomitant substance dependence. This review gives an overview of the current state of research in this field. Recent findings Although a large number of evaluation studies tested the effectiveness of several therapies for alcohol dependence, far fewer evaluated nonalcohol substance dependence. There are very few evaluations of the efficacy of psychotherapy for other forms of drug dependence. Only dialectical behavior therapy and dual-focus schema therapy have been tested for the treatment of personality disorder and substance dependence. Summary To date, two randomized controlled trials in 59 female-only patients with borderline personality disorder and substance abuse provided the best evidence-based data for the effectiveness of dialectical behavior therapy. For dual-focus schema therapy, a single randomized controlled trial indicated a curative effect in a small group of patients with personality disorder and substance dependence. Although the results of these studies are encouraging, further clinical trials need to be conducted in larger populations including male participants. © 2008 Lippincott Williams & Wilkins, Inc.