Operationalized Psychodynamic Diagnosis System and Outcome of Psychodynamic Inpatient Psychotherapy in Male and Female Patients.

Abstract:

OBJECTIVE:To compare male and female patients with regard to the Operationalized Psychodynamic Diagnosis (OPD-2) system, treatment variables, and outcome after multimodal psychodynamic inpatient psychotherapy. METHODS:At the beginning and at the end of inpatient treatment in a multimodal psychodynamic setting, patients were examined with the OPD-2 systemas well as with three self-assessment questionnaires addressing interpersonal problems (Inventory of Interpersonal Problems, IIP), and psychopathology: Brief SymptomInventory (BSI) and the Hospital Anxiety and Depression Scale (HADS). RESULTS:Data of 850 patients (238 males, 28%), 612 females, 72%) were available for analysis. There were differences between men and women in the main diagnoses, with a higher proportion of eating disorders and a longer treatment duration among the women. Therapy discontinuation rates were low and did not differ between the sexes. Women scored higher on psychopathology at admission on the BSIGlobal Score, IIP and anxiety; the pattern of reported interpersonal problems was consistent with sex roles. While the level of structural integration was similar in both sexes, the distribution of the two main conflicts and the level of improvement of awareness and dealing with the psychodynamic foci showed significant differences. Overall, at the end of inpatient psychotherapy, there was a mean improvement in both men and women, with no significant differences between them. Because of higher scores at the start of psychotherapy, the effect sizes for improvement were higher for women. CONCLUSIONS:On the whole, both sexes seem to benefit equally from psychodynamic inpatient psychotherapy in terms of symptom improvement. :Zusammenfassung Operationalisierte Psychodynamische Diagnostik und Outcome einer stationären psychodynamischen Psychotherapie bei Männern und Frauen Fragestellung: Vergleich der Operationalisierten Psychodynamischen Diagnostik (OPD), von Behandlungsvariablen und Outcome einer multimodalen stationären psychodynamischen Psychotherapie zwischen Männern und Frauen. Methoden: Zu Beginn und Ende einer multimodalen stationären psychodynamischen Psychotherapie wurden die OPD und Selbsteinschätzungsfragebögen erhoben, die interpersonelle Probleme (Inventar Interpersoneller Probleme IIP) und Psychopathologie erfassen: Brief Symptom Inventory (BSI) und Hospital Anxiety and Depression Scale (HADS). Ergebnisse: Auswertbare Daten lagen von 850 Patienten vor, davon 612 Frauen (72%). Es gab Geschlechterunterschiede bezüglich der Haupt-Behandlungsdiagnose, mit mehr Essstörungen und längerer Behandlungsdauer für Frauen. Die Abbruchraten waren niedrig und zwischen den Geschlechtern nicht unterschiedlich. Frauen hatten bei Aufnahme signifikant höhere Skalenwerte für den BSI-Globalwert, die IIP-Summe und Ängstlichkeit. Das Muster der berichteten interpersonellen Probleme entsprach gesellschaftlichen Geschlechterrollen. Weitere Geschlechterunterschiede fanden sich bezüglich der Verteilung der beiden neurotischen Hauptkonflikte und der Fokusveränderung auf der Heidelberger Umstrukturierungsskala, nicht jedoch im Strukturniveau. Beide Geschlechter zeigten signifikante Verbesserungen bezüglich der Psychopathologie von der Aufnahme zur Entlassung, ohne signifikante Geschlechterunterschiede. Aufgrund der höheren Symptomausprägung bei Aufnahme waren die Effektstärken bei Frauen höher. Diskussion: Insgesamt scheinen beide Geschlechter in ähnlichem Ausmaß von der stationären psychodynamischen Psychotherapie zu profitieren.

authors

Schneider G,Heuft G

doi

10.13109/zptm.2018.64.3.281

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

281-297

issue

3

eissn

1438-3608

issn

2196-8349

journal_volume

64

pub_type

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