A new European Child & Adolescent Psychiatry report followed participants from an adolescent DBT trial for an average of 12.4 years. Of the original 77 adolescents with recurrent suicidal or self-harming behavior and borderline features, 61 were reassessed at a mean age of 28.
Self-harm remained consistently less frequent among those originally assigned to DBT for adolescents. Across the full follow-up, participants who had received enhanced usual care reported more than twice as many self-harm episodes, amounting to an estimated mean difference of 90 episodes per person. Nevertheless, the between-group difference at the final assessment was not statistically significant. DBT’s earlier advantages for suicidal ideation, depression, and borderline symptoms also diminished over time and were no longer significant at the final follow-up. The small, predominantly female sample and retrospective reporting over long intervals limit certainty.
Clinical Takeaway: DBT-A’s most durable contribution may be reducing the accumulation of recurrent, high-frequency self-harm rather than permanently separating treated and comparison groups on every symptom. Continue to target life-threatening behavior first, but consider booster sessions, renewed chain analysis during transitions, caregiver or family support, and longer-term work on education, employment, relationships, and quality of life.