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Relative to the control group purchase cheap malegra dxt plus online erectile dysfunction kuala lumpur, the completers of the partial hospitalization program showed significant improvement: self-mutilation decreased buy malegra dxt plus 160 mg impotence after 50, the proportion of patients who attempted suicide decreased from 95% before treatment to 5% after treatment generic malegra dxt plus 160mg with visa erectile dysfunction causes cycling, and patients improved in terms of state and trait anxiety buy tadacip on line, depression buy tadora 20 mg on line, global symptoms buy cheap malegra dxt plus line, social adjustment, and interpersonal problems. In the last 6 months of the study, the number of inpatient episodes and duration of inpatient length of stay dramatically in- creased for the control subjects, whereas these utilization variables remained stable for subjects in the partial hospitalization group. One can conclude from this study that patients with borderline personality disorder treated with this program for 18 months showed significant improvement in terms of both symptoms and functioning. Reduction of symptoms and suicidal acts occurred after the first 6 months of treatment, but the differences in frequency and duration of inpatient treatment emerged only during the last 6 months of treatment. Although the principal treatment received by subjects in the partial hospitalization group was psychoanalytic individual and group therapy, one cannot definitively attribute this group’s better outcome to the type of therapy received, since the overall community support and social network within which these therapies took place may have exerted significant effects. Pharmacotherapy received was similar in the two treatment groups, but subjects in the partial Treatment of Patients With Borderline Personality Disorder 47 Copyright 2010, American Psychiatric Association. In a subsequent report (10), patients who had received partial hospitalization treatment not only maintained their substantial gains at an 18-month follow-up evaluation but also showed statistically significant continued improvement on most measures, whereas the control group showed only limited change during the same period. A study from Australia of twice-weekly psychodynamic therapy (20) prospectively com- pared the year before 12 months of psychodynamic therapy was given with the year after the therapy was received for a group of poorly functioning outpatients with borderline personality disorder. Although this study did not include a control group, there were dramatic improvements in patients that support the value of the yearlong treatment intervention. In another study (21), this same group of 30 patients who received psychodynamic therapy was compared with 30 control subjects drawn from an outpatient waiting list who then received treatment as usual, consisting of supportive therapy, cognitive therapy, and crisis intervention. The control subjects were assessed at baseline and at varying intervals, with an average follow- up duration of 17. In this nonrandomized controlled study, the group receiving psy- chodynamic therapy had a significantly better outcome than the control subjects (i. This study suggests that psychodynamic therapy is efficacious, but the in- vestigation has a number of limitations, including the lack of randomization, different follow- up durations for different subjects, nonblind assessment of outcome, and lack of detail about the amount of treatment received by the control subjects. Without more data on the amount of treatment received, it is unclear whether the better outcome of the subjects who received dynam- ic therapy was due to the type of therapy or the greater amount of treatment received. In Austra- lian dollars, the cost of the treatment for all patients decreased from $684,346 to $41,424. In- cluding psychotherapy in the cost of treatment, there was a total savings per patient of $8,431 per year. This cost-effectiveness was accounted for almost entirely by a decrease in the number of hospital days. Without a control group, however, one cannot definitively conclude that the cost savings were the result of the psychotherapy. In the aforementioned randomized controlled trial of psychoanalytically focused partial hospitalization treatment (9), the effect of psychotherapy on reducing hospitalization was not significant until after the pa- tients had been in therapy for more than 12 months. There are no studies demonstrating that brief therapy or psychotherapy less than twice a week is helpful for patients with borderline per- sonality disorder.