Outcome assessment in complex therapeutic-rehabilitative treatments for personality disorders: a systematic review

Personality disorders (PD) have a large social impact on the general population. Currently, the literature offers evidence of therapeutic outcomes pursued in the outpatient setting and focused mainly on psychotherapy. To date, a limited number of studies seem to have focused on the effects of residential multimodal treatments specifically based on several psychosocial interventions. Commensurate with this statement, a review has been conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The objective was to map the literature with the purpose of identifying which methods and tools were used to assess therapeutic intervention outcomes in multimodal contexts. Among the 718 studies published between 2000 and 2022, 23 of them met the criteria to be included in the present review. Despite the many limitations, it is possible to state which are the most relevant characteristics considered in these previous studies: (a) the areas evaluated at the end of complex treatments are clinical, psychosocial functioning and use of services; (b) the overall therapeutic outcome was assessed through the use of many measuring instruments; and (c) evaluation of integrated therapeutic processes that lead to an improvement in the clinical picture of patients seems to be the most complex aspect to deal with. In conclusion, to fully understand which are the most relevant areas that contribute to the evaluation of therapeutic outcome in residential multimodal treatments, specifically based on several psychosocial interventions, more studies (hopefully also innovative) are needed.