Contenido principal del artículo

Arianna Denisse Hurtado Armijos
Evelyn Tatiana Abad Loaiza

La terapia basada en la mentalización busca fortalecer la comprensión de los estados mentales propios y ajenos para favorecer la regulación emocional. El objetivo de esta revisión fue analizar la eficacia clínica de la terapia basada en la mentalización frente al riesgo suicida en adultos con diagnóstico de trastorno límite de la personalidad. Se realizó una revisión sistemática siguiendo las directrices PRISMA 2020, donde la búsqueda se efectuó en PubMed, Scopus, Dialnet y SciELO. Los resultados mostraron reducción de las manifestaciones del riesgo suicida tras la aplicación de la terapia, con tasas de remisión superiores al setenta por ciento en autolesiones. Se concluye que la terapia basada en la mentalización constituye una intervención eficaz para la reducción del riesgo suicida en pacientes con trastorno límite de la personalidad.

Mentalization-based therapy aims to strengthen the understanding of one's own and others' mental states to promote emotional regulation. The objective of this review was to analyze the clinical efficacy of mentalization-based therapy against suicidal risk in adults diagnosed with borderline personality disorder. A systematic review was conducted following the 2020 PRISMA guidelines, searching PubMed, Scopus, Dialnet, and SciELO. The results showed a reduction in manifestations of suicidal risk after the application of the therapy, with remission rates exceeding seventy percent for self-harm. It is concluded that mentalization-based therapy is an effective intervention for reducing suicidal risk in patients with borderline personality disorder.

Descargas

Los datos de descargas todavía no están disponibles.

Detalles del artículo

Cómo citar
Hurtado Armijos, A. D., & Abad Loaiza, E. T. (2026). Mentalización y riesgo suicida en pacientes con trastorno límite de la personalidad: revisión sistemática. Revista Ecuatoriana De Psicología, 9(24), 172–187. https://doi.org/10.33996/repsi.v9i24.234
Sección
ARTÍCULO DE REVISIÓN
Bookmark and Share
Referencias

Asarnow, J. R., Berk, M. S., Bedics, J., Adrian, M., Gallop, R., Cohen, J., Korslund, K., Hughes, J., Avina, C., Linehan, M. M., & McCauley, E. (2021). Dialectical behavior therapy for suicidal self-harming youth: Emotion regulation, mechanisms, and mediators. Journal of the American Academy of Child & Adolescent Psychiatry, 60(9), 1105–1115.e4. https://doi.org/10.1016/j.jaac.2021.01.016

Balzen, K. M., & Sharp, C. (2024). The contribution of mentalization-based theory and practice for understanding and treating self-injurious behavior in young people. Journal of Infant, Child, and Adolescent Psychotherapy, 23(1), 108–121. https://doi.org/10.1080/15289168.2024.2311555

Bateman, A., Constantinou, M. P., Fonagy, P., & Holzer, S. (2021). Eight-year prospective follow-up of mentalization-based treatment versus structured clinical management for people with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 12(4), 291–299. https://doi.org/10.1037/per0000422

Bateman, A., & Fonagy, P. (2010). Mentalization based treatment for borderline personality disorder. World Psychiatry, 9(1), 11–15. https://doi.org/10.1002/j.2051-5545.2010.tb00255.x

Beattie, D., Murphy, S., Jamieson, S. & Lee, A. (2022). Running a mentalization-based treatment (MBT) programme within a public community adult mental health service setting: a feasibility study. Irish Journal of Psychological Medicine, 39(1), 28-38. https://doi.org/10.1017/ipm.2019.7

Bersani, F. S., Accinni, T., Carbone, G. A., Corazza, O., Panno, A., Prevete, E., Bernabei, L., Massullo, C., Burkauskas, J., Tarsitani, L., Pasquini, M., Biondi, M., Farina, B., & Imperatori, C. (2022). Problematic use of the internet mediates the association between reduced mentalization and suicidal ideation: A cross-sectional study in young adults. Healthcare, 10(5), Article 948. https://doi.org/10.3390/healthcare10050948

Carlyle, D., Green, R., Inder, M., Porter, R., Crowe, M., Mulder, R. & Frampton, C. (2020). A randomized-controlled trial of mentalization-based treatment compared with structured case management for borderline personality disorder in a mainstream public health service. Frontiers in psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.561916

Carpita, B., Nardi, B., Giovannoni, F., De Felice, C., Tranchese, F., Bonelli, C., Massimetti, G., Cremone, I. M., Pini, S., Muscatello, M. R. A., & Dell’Osso, L. (2025). Autistic traits are associated with suicidal thoughts and behaviors among patients with borderline personality disorder. Brain Sciences, 15(4), Article 340. https://doi.org/10.3390/brainsci15040340

de Freixo Ferreira, L., Guerra, C., & Vieira-Coelho, M. A. (2023). Predictors of psychotherapy dropout in patients with borderline personality disorder: A systematic review. Clinical Psychology & Psychotherapy, 30(6), 1324–1337. https://doi.org/10.1002/cpp.2888

Doyle, M., Collins, A., Wheeler, A., McAndrew, J., Burgess, N., Byrne, G., O’Keeffe, D., & Naughton, S. (2025). Exploration of a mentalization-based treatment introductory group in an Irish community mental health service. Irish Journal of Psychological Medicine, 43(2), 167–174. https://doi.org/10.1017/ipm.2025.10085

Folmo, E. J., Stänicke, E., Johansen, M. S., Pedersen, G., & Kvarstein, E. H. (2021). Development of therapeutic alliance in mentalization-based treatment—Goals, bonds, and tasks in a specialized treatment for borderline personality disorder. Psychotherapy Research, 31(5), 604–618. https://doi.org/10.1080/10503307.2020.1831097

Fonagy, P. & Bateman, A. W. (2020). Mechanisms of change in mentalization-based treatment of borderline personality disorder. In The organic and the inner world (pp. 23-55). Routledge. https://books.google.com.cu/books?hl=es&lr=&id=KulgDwAAQBAJ&oi=fnd&pg=PA23&ots=Ly0Pn3vNw1&sig=ybD887Zx3xuLj9qdNUtWxYLxIFk&redir_esc=y

Galvez, A., Perez, I., Lopez, J. M., De la Torre, A., Díaz, S., Diaz, M. & Carrasco, J. L. (2025). Study of social cognition as a risk factor for self-injurious behavior in borderline personality disorder: an exploratory analysis with machine learning. The European Journal of Psychiatry, 39(4). https://doi.org/10.1016/j.ejpsy.2025.100321

Gunderson, J. G., Stout, R. L., McGlashan, T. H., Shea, M. T., Morey, L. C., Grilo, C. M., Zanarini, M. C., Yen, S., Markowitz, J. C., Sanislow, C., Ansell, E., Pinto, A., & Skodol, A. E. (2011). Ten-year course of borderline personality disorder: Psychopathology and function from the Collaborative Longitudinal Personality Disorders Study. Archives of General Psychiatry, 68(8), 827–837. https://doi.org/10.1001/archgenpsychiatry.2011.37

Hajek Gross, C., Oehlke, S.-M., Prillinger, K., Goreis, A., Plener, P. L., & Kothgassner, O. D. (2024). Efficacy of mentalization-based therapy in treating self-harm: A systematic review and meta-analysis. Suicide and Life-Threatening Behavior, 54(2), 317–337. https://doi.org/10.1111/sltb.13044

Harpøth, T. S. D., Kongerslev, M. T., Moeyaert, M., Bo, S., Bateman, A. W., & Simonsen, E. (2020). Evaluating “mentalizing positive affect” as an intervention for enhancing positive affectivity in borderline personality disorder using a single-case multiple-baseline design. Psychotherapy, 57(4), 580–586. https://doi.org/10.1037/pst0000251

Johnstone, O. K., Marshall, J. J. & McIntosh, L. G. (2022). A review comparing dialectical behavior therapy and mentalization for adolescents with borderline personality traits, suicide and self-harming behavior. Adolescent research review, 7(2), 187-209. https://doi.org/10.1007/s40894-020-00147-w

Jørgensen, M. S., Høgenhaug, S. S., Sharp, C., & Bo, S. (2025). Mentalization-based therapy for borderline personality disorder: State-of-the-science and future directions. Clinical Psychology & Psychotherapy, 32(4), Article e70120. https://doi.org/10.1002/cpp.70120

Juul, S., Jakobsen, J. C., Hestbaek, E., Jørgensen, C. K., Olsen, M. H., Rishede, M., Frandsen, F. W., Bo, S., Lunn, S., Poulsen, S., Sørensen, P., Bateman, A., & Simonsen, S. (2023). Short-term versus long-term mentalization-based therapy for borderline personality disorder: A randomized clinical trial (MBT-RCT). Psychotherapy and Psychosomatics, 92(5), 329–339. https://doi.org/10.1159/000534289

Karabulut, S. & Uçkun, S. U. (2025). The Association Between Theory of Mind, Psychopathic Traits, Borderline Personality Traits, and Severity of Substance Use Disorder in Women: A Comparative Analysis. Alpha Psychiatry, 26(3). https://doi.org/10.31083/AP44175

Karterud, S. (2015). Mentalization-Based Group Therapy (MBT-G): A theoretical, clinical, and research manual. OUP Oxford. https://books.google.com.cu/books?hl=es&lr=&id=lUpoCgAAQBAJ&oi=fnd&pg=PP1&dq=Mentalization-based+group+therapy+(MBT-G):+A+theoretical,+clinical,+and+research+manual.+Oxford+University+Press&ots=04dL_6UIU0&sig=4o_teVMek_E6lpicB504576Tqo4&redir_esc=y

Katani, A. M., Ebrahimi, M. R., Rahnejat, A. M., Mohammadimehr, M., Shahmiri Barzoki, H., & Jamil, L. (2026). Investigating the efficacy of mentalization-based psychoeducational intervention on self-harm, difficulty in emotional regulation, and mentalization of soldiers with borderline personality disorder who engage in self-harm behaviors. Journal of Education and Health Promotion, 15, Article 105. https://doi.org/10.4103/jehp.jehp_1962_24

Kılıç, F., Demirdaş, A., Işık, Ü., Akkuş, M., Atay, İ. M., & Kuzugüdenlioğlu, D. (2020). Empathy, alexithymia, and theory of mind in borderline personality disorder. The Journal of Nervous and Mental Disease, 208(9), 736–741. https://doi.org/10.1097/NMD.0000000000001196

Kothgassner, O. D., Goreis, A., Robinson, K., Huscsava, M. M., Schmahl, C. & Plener, P. L. (2021). Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis. Psychological medicine, 51(7), 1057-1067. https://doi.org/10.1017/S0033291721001355

Kvarstein, E. H., Bremer, K., Baltzersen, Å. L., Ekberg, A., Normann-Eide, E., Ulvestad, D. A., Pedersen, G., & Wilberg, T. (2025). Sustainability of mentalization-based treatment programs for poorly functioning patients with borderline personality disorder. Can we really keep it up? Personality and Mental Health, 19(4), Article e70036. https://doi.org/10.1002/pmh.70036

Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024). Borderline personality disorder: A comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23(1), 4–25. https://doi.org/10.1002/wps.21156

Luyten, P., Campbell, C., Allison, E. & Fonagy, P. (2020). The mentalizing approach to psychopathology: State of the art and future directions. Annual review of clinical psychology, 16(1), 297-325. https://doi.org/10.1146/annurev-clinpsy-071919-015355

Luyten, P., Campbell, C., Moser, M. & Fonagy, P. (2024). The role of mentalizing in psychological interventions in adults: Systematic review and recommendations for future research. Clinical Psychology Review, 108. https://doi.org/10.1016/j.cpr.2024.102380

Luyten, P., De Meulemeester, C. & Fonagy, P. (2021). The self–other distinction in psychopathology: Recent developments from a mentalizing perspective. In The neural basis of mentalizing (pp. 659-680). Springer. https://doi.org/10.1007/978-3-030-51890-5_34

McClelland, H., Cleare, S. & O’Connor, R. (2023). Suicide risk in personality disorders: A systematic review. Current psychiatry reports, 25(9), 405-417. https://doi.org/10.1007/s11920-023-01440-w

McLaren, V., Gallagher, M., Hopwood, C. J., & Sharp, C. (2022). Hypermentalizing and borderline personality disorder: A meta-analytic review. American Journal of Psychotherapy, 75(1), 21–31. https://doi.org/10.1176/appi.psychotherapy.20210018

McMain, S. F., Chapman, A. L., Kuo, J. R., Dixon-Gordon, K. L., Guimond, T. H., Labrish, C., Isaranuwatchai, W., & Streiner, D. L. (2022). The effectiveness of 6 versus 12 months of dialectical behavior therapy for borderline personality disorder: A noninferiority randomized clinical trial. Psychotherapy and Psychosomatics, 91(6), 382–397. https://doi.org/10.1159/000525102

Mohamed, M. M., Saad, A., Elmeguid, M. A., Elsayed, R. & Mohamed, Z. (2021). Affective theory of the mind and suicide in women with borderline personality disorder and schizophrenia: a comparative study. Middle East Current Psychiatry, 28(1), 64. https://doi.org/10.1186/s43045-021-00142-4

Muskens, L., Bouwmeester, S., Nooijen, M., & Bachrach, N. (2024). Intelligence and treatment outcome of mentalization-based treatment in borderline personality disorder. Clinical Psychology & Psychotherapy, 31(5), Article e3061. https://doi.org/10.1002/cpp.3061

Nestor, B. A., & Sutherland, S. (2022). Theory of mind and suicidality: A meta-analysis. Archives of Suicide Research, 26(4), 1666–1687. https://doi.org/10.1080/13811118.2021.1939209

Rodríguez Quiroga, A., Aufenacker, S. I., Aschiero, M. B., Antequera, M. F., & Grasso, L. (2024). Revisión sistemática: Intervenciones basadas en mentalización para población general y como complemento clínico. Interdisciplinaria, 41(2), 5–22. https://repositorio.uca.edu.ar/handle/123456789/19182

Rizzi, E., Weijers, J. G., Kate, C. & Selten, J. P. (2024). Mentalization based treatment for a broad range of personality disorders: a naturalistic study. BMC psychiatry, 24(1). https://doi.org/10.1186/s12888-024-05865-2

Ruocco, A. C. & Marceau, E. M. (2024). Update on the neurobiology of borderline personality disorder: A review of structural, resting-state and task-based brain imaging studies. Current psychiatry reports, 26(12), 807-815. https://doi.org/10.1007/s11920-024-01553-w

Setkowski, K., Palantza, C., van Ballegooijen, W., Gilissen, R., Oud, M., Cristea, I. A., Noma, H., Furukawa, T. A., Arntz, A., van Balkom, A. J. L. M., & Cuijpers, P. (2023). Which psychotherapy is most effective and acceptable in the treatment of adults with a (sub)clinical borderline personality disorder? A systematic review and network meta-analysis. Psychological Medicine, 53(8), 3261–3280. https://doi.org/10.1017/S0033291723000685

Stoffers, J. M., Völlm, B. A., Rücker, G., Timmer, A. & Huband, N. (2012). Psychological therapies for people with borderline personality disorder. Cochrane database of systematic reviews(8). https://doi.org/10.1002/14651858.CD005652.pub2

Tomko, R. L., Trull, T. J., Wood, P. K. & Sher, K. J. (2014). Characteristics of borderline personality disorder in a community sample: comorbidity, treatment utilization, and general functioning. Journal of personality disorders, 28(5), 734-750. https://doi.org/10.1521/pedi_2012_26_093

Torghabeh, L. H. & Najafi, M. (2026). The Effectiveness of Combined Eye Movement Desensitization and Reprocessing and Dialectical Behavior Therapy on Mentalization Components and Suicidal Ideation in Individuals with Borderline Personality Disorder. Journal of Research in Psychopathology, 7(2). https://doi.org/10.22098/jrp.2026.19237.1358

Uzar, M., Dmitrzak, M. & Słopień, A. (2023). Mentalizing in adolescents with borderline personality disorder. Brain Sciences, 13(10), 1473. https://doi.org/10.3390/brainsci13101473

Wilson, J., Gee, B., Martin, N., Maxwell, S., Murdoch, J., Clarke, T., Clark, A., Turner, D., Katangwe-Chigamba, T., Jones, P. B., & Fonagy, P. (2025). Feasibility randomised controlled trial of a brief psychological intervention for adolescents with borderline personality disorder symptoms delivered with schools and colleges. Pilot and Feasibility Studies, 11, Article 102. https://doi.org/10.1186/s40814-025-01679-5

Wolfs, B. (2024). Mentalisation-based treatment for borderline personality disorder: A narrative review of recent process and outcome findings. Psychodynamic Practice, 30(4), 381–399. https://doi.org/10.1080/14753634.2024.2343697