Treatment of Borderline Personality Disorder With Psychoanalytically Oriented Partial Hospitalization: An 18-Month Follow-Up

• Published in: The American journal of psychiatry Vol. 158; no. 1; pp. 36 - 42
• Main Authors: Bateman, Anthony, Fonagy, Peter
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01.01.2001; American Psychiatric Association
• Subjects: Biological and medical sciences; Borderline personality disorder; Borderline Personality Disorder - diagnosis; Borderline Personality Disorder - epidemiology; Borderline Personality Disorder - therapy; Clinical outcomes; Comorbidity; Day Care, Medical; Day hospitals; Depressive Disorder - diagnosis; Depressive Disorder - epidemiology; Depressive Disorder - psychology; Follow-Up Studies; Followup studies; Hospitalization; Humans; Institution therapy. Inpatient treatment; Interpersonal Relations; Length of Stay; Medical sciences; Mental disorders; Personality; Personality Inventory - statistics & numerical data; Psychoanalysis; Psychoanalytic Therapy; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self-Injurious Behavior - diagnosis; Self-Injurious Behavior - epidemiology; Social Adjustment; Suicide, Attempted - statistics & numerical data; Treatment Outcome; Treatments; Mood disorder; Human; Analytical psychotherapy; Borderline; Treatment efficiency; Use; Social adjustment; Depression; Hospitalization; Health service; Group analytical psychotherapy; Personality disorder; Suicide attempt; Symptomatology; Treatment; Partial; Criterion; Follow up study; Anxiety; Therapeutic schedule; Interpersonal relation
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.158.1.36

OBJECTIVE: The aim of this study was to determine whether the substantial gains made by patients with borderline personality disorder following completion of a psychoanalytically oriented partial hospitalization program, in comparison to patients treated with standard psychiatric care, were maintained over an 18-month follow-up period. METHOD: Forty-four patients who participated in the original study were assessed every 3 months after completion of the treatment phase. Outcome measures included frequency of suicide attempts and acts of self-harm, number and duration of inpatient admissions, service utilization, and self-reported measures of depression, anxiety, general symptom distress, interpersonal functioning, and social adjustment. RESULTS: Patients who completed the partial hospitalization program not only maintained their substantial gains but also showed a statistically significant continued improvement on most measures in contrast to the patients treated with standard psychiatric care, who showed only limited change during the same period. CONCLUSIONS: The superiority of psychoanalytically oriented partial hospitalization over standard psychiatric treatment found in a previous randomized, controlled trial was maintained over an 18-month follow-up period. Continued improvement in social and interpersonal functioning suggests that longer-term changes were stimulated.