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1.
Z Psychosom Med Psychother ; 65(3): 288-303, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476999

RESUMO

Is the influence of religiousness on fearful, depressive and somatic symptoms and psychic traumatization overestimated? A representative cross-sectional study Objectives: The aim of this study is to prove if religious faith, spirituality and religious praxis are joined with lower depression, anxiety and physical pain-level and if subjects with traumatic experiences report more spirituality. Methods: In this consecutive study, 2508 adults of a representative sample in Germany were interviewed about religious faith and spirituality in relation to depression, anxiety, physical disorders as well as traumatic experiences. Results: Unlike our hypotheses people who are charged with mental (PHQ-4; Löwe et al. 2010) or physical disorders (GBB_8; Kliem et al. 2017) report more spirituality and more private religious/spiritual praxis than people without mental or physical problems. As expected people with traumatic experiences in their childhood (CTS; Grabe et al. 2012) describe significantly more spirituality than people without these experiences. Conclusions: Other than expected people with more mental or physical disorders report more spirituality and more private religious/spiritual praxis. It is to discuss if spirituality is less a protective factor for mental or physical disorders than disorders activate to look for spirituality and private religious/spiritual praxis.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Medo/psicologia , Sintomas Inexplicáveis , Trauma Psicológico/psicologia , Religião e Psicologia , Espiritualidade , Adulto , Ansiedade/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Alemanha/epidemiologia , Humanos , Entrevistas como Assunto , Trauma Psicológico/epidemiologia
2.
J Pers Disord ; : 1-20, 2019 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-30785864

RESUMO

This study examines emotional experience in major depressive disorder (MDD) with and without comorbid borderline personality disorder (BPD). It investigates if depression severity or personality functioning mediates group differences and which aspects of emotional experience change during psychotherapy. The emotional experience of MDD-BPD patients (n = 44) was compared to MDD-only patients (n = 35) before and after multimodal short-term psychotherapy. Emotions were classified based on valence and an active/passive polarity. MDD-BPD patients exhibited more active-negative emotions. This group difference was mediated by the level of personality functioning, but not by depression severity. Although passive-negative emotions decreased and positive emotions increased during therapy, there was no significant change in active-negative emotions. The two patient groups did not significantly differ in the change of emotional experience. Lower levels of personality functioning in depressed patients with BPD are associated with a broader spectrum of negative emotions, specifically more active-negative emotions.

3.
J Clin Psychol ; 2018 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-30216437

RESUMO

OBJECTIVE: The aim of this study was to investigate associations between patients' subjective agency, their observable in-session behavior, and the patient-therapist interaction during the early phase of psychotherapy. METHODS: The sample included 52 depressed patients in psychodynamic psychotherapy. After Session 5, the patients' agency and the quality of the therapeutic alliance were assessed. Based on session recordings, two independent observers rated the patients' involvement, their interpersonal behavior, and the therapists' directiveness. RESULTS: Higher agency was associated with stronger therapeutic alliances. Patients who indicated higher agency in their therapy participated more actively in the session and showed less hostile impact messages. Patients' agency was not related to therapists' directiveness. CONCLUSIONS: Patients' sense of agency in psychotherapy was associated with more active involvement and affiliative interaction. The findings support the idea that patients need to feel capable of acting within and having an influence on their therapy to benefit from it.

4.
Psychotherapy (Chic) ; 55(3): 209-215, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30179028

RESUMO

Interpersonal characteristics contribute to therapists' ability to form helpful working alliances with their patients. But how are attachment styles and interpersonal motives distributed among therapist trainees? This study examines attachment styles and interpersonal motives of therapist trainees by comparing them with matched reference samples from representative surveys. A total sample of 285 trainees, who were enrolled in either cognitive-behavioral or psychodynamic therapy training programs, was recruited via their training institutes. Participants answered questionnaires on attachment (Experiences in Close Relationships-Revised, 36-item version, and Experiences in Close Relationships-Revised, 8-item version) and interpersonal motives (Circumplex Scales of Interpersonal Values). Compared with 2 matched nonclinical reference samples from representative surveys, therapist trainees reported lower scores on attachment-related avoidance and higher scores on harmonious interpersonal motives. Therapist trainees are characterized by a wish for warm proximity with others and feel comfortable in close relationships. (PsycINFO Database Record

5.
Am J Psychiatry ; 175(10): 961-969, 2018 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-30068262

RESUMO

OBJECTIVE:: An increased understanding of repetitive dysfunctional patterns and their relationship to an individual's life history is regarded as a key mechanism of change in insight-oriented therapies. At the same time, empirical research on the insight-outcome relationship is rare, and its generalizability is restricted by the use of a wide range of definitions and methods among studies. The authors conducted a meta-analysis to systematically examine the association between patient insight and psychotherapy outcome across a range of treatment modalities. METHOD:: Insight was defined as patients' understanding of associations between past and present experiences, typical relationship patterns, and the relation between interpersonal challenges, emotional experience, and psychological symptoms. From 13,849 initially identified abstracts, the authors extracted 23 independent effect sizes. A random-effects meta-analysis was performed to assess the magnitude of the insight-outcome relationship. Risk of publication bias was assessed with funnel plot inspections, Egger's regression test, and Duval and Tweedie's trim-and-fill procedure as sensitivity analyses. RESULTS:: A significant, moderate correlation (r=0.31) was observed between insight and treatment outcome. Sensitivity analyses demonstrated the robustness of the results. CONCLUSIONS:: The findings support the importance of insight for psychotherapy outcome. Insight may be a relevant mechanism of change across different treatment modalities.

6.
Artigo em Alemão | MEDLINE | ID: mdl-29847846

RESUMO

This article reports about a new treatment setting, the Psychotherapeutic Evening Clinic at the University Hospital Heidelberg. The treatment intensity is ranked between intensive, full-day inpatient and day-clinic programs in hospitals and less frequent outpatient psychotherapy according to the Germany Psychotherapy Guideline. Patients attend the Evening Clinic on 3 evenings per week for 3 hours each. During this time, they receive group therapy, individual therapy, mindfulness exercises and psychotherapeutic ward rounds. The first experiences with the new setting are positive, a specific advantage is the possibility to include daily hassles and everyday stressors as well as patients' strengths and resources into the treatment. Therapeutic challenges are the potential of overburdening patients with an already high impairment. On the structural and political level it will be important to ensure funding for the new treatment setting.

7.
Psychother Res ; : 1-16, 2018 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-29557306

RESUMO

OBJECTIVES: Therapeutic agency is defined as a patient's intentional influence over the process of psychotherapeutic change. However, there is a lack of conceptually sound self-report measures with adequate psychometric properties. The aim of this study was to develop and psychometrically evaluate the patient-rated Therapeutic Agency Inventory (TAI). METHOD: Based on the literature, we developed items related to therapeutic agency and investigated their psychometric properties in a naturalistic study with a sample of 334 psychotherapy participants. We assessed changes in TAI scores in a subsample of 58 patients over the course of inpatient psychotherapy and related TAI scores to therapeutic improvement. RESULTS: The TAI consists of 15 items. We performed exploratory factor analyses, and the following three factors were extracted: In-session activity, therapy-related processing, and therapist-oriented passivity. Internal consistency was .84 for the total score and ranged between .73 and .80 for each of the factors. The TAI was significantly associated with other psychotherapy process factors, self-efficacy expectations, control beliefs, lower overall psychological distress, and lower depression scores. Changes in agency during psychotherapy predicted therapy outcome, even after controlling for baseline distress. CONCLUSIONS: The TAI is a reliable, valid, and change-sensitive self-report instrument that can be used to assess agency in psychotherapy.

8.
PLoS One ; 13(1): e0191254, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29360832

RESUMO

Attachment theory helps us to understand patients´ health behavior. Attachment styles might explain patient differences in coping behavior, self-treatment, or patient-provider relationships. In primary care time constrains are relevant. A short instrument may facilitate screening and assessment in daily medical practice. The aim of this study was to evaluate a 12-item short version of the Experience in Close Relationships-revised (ECR-R-D) to be used in primary care settings. We included 249 patients from ten general practices in central Germany into a cross-sectional study. Exploratory factor analysis was performed to evaluate the factor structure of the ECR-items. Cronbach's alpha was used to assess internal consistency. The results related to the short form of the ECR are in line with those of the German full-length version of the measure (ECR-RD 36). Internal consistencies were in an adequate range. The ECR short form can be recommended as a screening measure of attachment styles in primary care.


Assuntos
Atenção Primária à Saúde , Relações Profissional-Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Análise Fatorial , Feminino , Alemanha , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Apego ao Objeto , Inquéritos e Questionários , Adulto Jovem
9.
Clin Psychol Psychother ; 24(5): 1040-1046, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28064469

RESUMO

Reduced self-esteem is a core symptom of depression, but few studies have investigated within-treatment change of self-esteem as a predictor of long-term outcome in depression. This study investigated change in self-esteem during 8 weeks of multimodal, psychodynamically oriented psychotherapy for 40 depressed patients and tested whether it would predict outcome 6 months after termination. Data was drawn from a randomized clinical pilot trial on day-clinic versus inpatient psychotherapy for depression. Findings supported the association between change in self-esteem and follow-up depression severity, even when controlling for within-treatment symptom change. Change in self-esteem was not related to overall symptoms and interpersonal problems at follow-up. Thus, change in self-esteem may be an important variable in preventing relapse for depression. KEY PRACTITIONER MESSAGE: Self-esteem is related to depressive symptoms and interpersonal problems. Improvement of self-esteem during psychotherapy correlates with improvements of symptoms and interpersonal problems. Change of self-esteem during psychotherapy predicts depressive symptoms 6 months after termination of therapy. When treating depressed patients, psychotherapists should work towards an improvement of self-esteem in order to prevent relapse.


Assuntos
Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/terapia , Psicoterapia Psicodinâmica/métodos , Autoimagem , Adolescente , Adulto , Terapia Combinada/métodos , Feminino , Seguimentos , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
10.
Clin Psychol Psychother ; 24(2): 384-391, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26818665

RESUMO

Several theories suggest that self-focused attention plays an important role in the maintenance of depression. However, previous studies have predominantly relied on self-report and laboratory-based measures such as sentence completion tasks to assess individual differences in self-focus. We present a prospective, longitudinal study based on a sample of 29 inpatients with clinical depression, investigating whether an implicit, behavioural measure of self-focused attention, i.e., the relative frequency of first-person singular pronouns in naturally spoken language, predicts depressive symptoms at follow-up over and above initial depression. We did not find a significant cross-sectional association between depressive symptoms and first-person singular pronoun use. However, first-person singular pronoun use significantly predicted depressive symptoms approximately 8 months later, even after controlling for depressive symptoms at baseline or discharge. Exploratory analyses revealed that this effect was mainly driven by the use of objective and possessive self-references such as 'me' or 'my'. Our findings are in line with theories that highlight individual differences in self-focused attention as a predictor of the course of depression. Moreover, our findings extend previous work in this field by adopting an unobtrusive approach of non-reactive assessment, capturing naturally occurring differences in self-focused attention. We discuss possible clinical applications of language-based assessments and interventions with regard to self-focus. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Naturally occurring individual differences in first-person singular pronoun use provide an unobtrusive way to assess patients' automatic self-focused attention. Frequent use of first-person singular pronouns predicts an unfavourable course of depression. Self-focused language might offer innovative ways of tracking and targeting therapeutic change.


Assuntos
Transtorno Depressivo/psicologia , Pacientes Internados/psicologia , Linguagem , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
11.
Z Psychosom Med Psychother ; 62(3): 252-69, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27594602

RESUMO

OBJECTIVES: Anxiety disorders, most notably panic disorders and agoraphobia, are common mental disorders, and there is a high comorbidity with personality disorders. Randomized controlled trails addressing this highly relevant group of patients are missing. DESIGN: The multicenter Anxiety and Personality Disorders (APD) study investigates 200 patients with panic disorder and/or agoraphobia with comorbid personality disorder in a randomized control-group comparison of psychoanalytic therapy (PT) and cognitive behavioral therapy (CBT), including 100 patients in each group. Each patient will be examined over a period of six years, regardless of the duration of the individual treatment. The main issues that are addressed in this study are the comparison of the efficacy of PT and CBT in this special patient population, the comparison of the sustainability of the effects of PT and CBT, the comparison of the long-term cost-benefit-ratios of PT and CBT as well as the investigation of prescriptive patient characteristics for individualized treatment recommendations (differential indication). DISCUSSION: The APD study compares efficacy, sustainability, and cost-benefit-ratios of CBT and PT for anxiety plus personality disorders in a randomized controlled trail. The study design meets the requirements for an efficacy study for PT, which were recently defined. TRIAL REGISTRATION: Current Controlled Trials ISRCTN12449681.


Assuntos
Agorafobia/terapia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental , Transtorno de Pânico/terapia , Transtornos da Personalidade/terapia , Terapia Psicanalítica , Agorafobia/diagnóstico , Agorafobia/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Comorbidade , Seguimentos , Humanos , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/psicologia , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia
12.
J Affect Disord ; 205: 264-268, 2016 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-27472169

RESUMO

OBJECTIVE: The study represents a conceptual replication of the study by Eng et al. (2001) in a sample of adult patients diagnosed with social anxiety disorder as primary diagnosis. METHODS: Two different attachment questionnaires (Bielefeld Questionnaire of Client Expectations (BQCE) and Experiences in Close Relationships (ECR-RD)) were applied to examine whether the effect of attachment on depression (measured by the BDI) is mediated by social anxiety (measured by the LSAS) in a cross-sectional study. RESULTS: The data confirms such a mediation. The effect of attachment measured with the BQCE on depression was completely mediated, whereas the effect of both scales of the ECR-RD (attachment related avoidance and anxiety) on depression was only partially mediated by social anxiety disorder. CONCLUSION: The study supports the association of attachment, social anxiety, and depressive symptoms and the need to consider different perspectives on attachment.


Assuntos
Transtorno Depressivo/psicologia , Apego ao Objeto , Fobia Social/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Inquéritos e Questionários
13.
Int J Ment Health Syst ; 10: 41, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27222663

RESUMO

OBJECTIVE: Depressive disorders are among the most common psychiatric disorders. For severely depressed patients, day clinic and inpatient settings represent important treatment options. However, little is known about patients' perceptions of the different levels of care. This study aimed to obtain an in-depth analysis of depressive patients' experiences of day clinic and inpatient treatment in a combined clinical setting. METHODS: Following a randomized controlled trial comparing day clinic and inpatient psychotherapy for depression (Dinger et al. in Psychother Psychosom 83:194-195, 2014), a sample of depressive patients (n = 35) was invited to participate in a semi-structured interview during an early follow up 4 weeks after discharge. A qualitative analysis of interview transcripts was performed following the principles of constructivist thematic analysis. RESULTS: Following analysis, 1355 single codes were identified from which five main categories and 26 themes were derived for both groups. In regard to patient group integration and skill transfer to everyday life, distinct differences could be observed between the day clinic and inpatient group. CONCLUSION: While adjustment to therapeutic setting and patient group integration seem to be facilitated by inpatient treatment, the day clinical setting appears to promote treatment integration into patients' everyday contexts, aiding treatment-related skill transfer to everyday life as well as alleviating discharge from clinic treatment. Further studies on depressive subject groups in day clinic and inpatient treatment should investigate aspects of group cohesion and treatment integration in relation to therapeutic outcome.

14.
Psychother Psychosom Med Psychol ; 66(2): 88-92, 2016 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-26859112

RESUMO

INTRODUCTION: From year one of studying medicine an increase of psychological stress is found. The relationship between the occurrence of this stress and attachment patterns or structural personality functions remains unclear. The present study aimed at investigating whether a relationship between the enduring personality variables, attachment style and level of structural integration of the personality, and acute stress experience at the beginning of medical students' studies exists. MATERIAL & METHODS: In this study, all students in the first semester of medicine were invited to participate in a study to identify stress factors via questionnaire (MBI-SS, PSQ, PHQ-9, GAD-7) in the WS 2013/2014. Simultaneously, the predominant attachment style (RQ-2) and structural abilities (OPD-SFK) were evaluated. RESULTS: The study included 293 students (return: 91.3%). Securely attached students experienced significantly less stress than insecurely attached students (p=0.019). Students with a high level of structural integration showed significantly less stress burden (p<0.001) and lower exhaustion- (p<0.001) and cynicism values (p<0.001), while showing a higher experience of self-efficacy (p<0.001). The influence of attachment behavior on stress experience is mediated by the level of the structural integration of the personality. DISCUSSION: Significant correlations exist between attachment style and the level of structural integration of the personality, and burnout risk as well as stress burden. The level of structural integration of the personality mediates the relationship between the attachment-related "model of self" and stress experience, i. e. a positive "model of self" can have a stress-protective effect when good structural abilities are present. Practical implication: An insecure attachment style and a low level of structural integration may be associated with higher stress experience when transitioning to study. The results suggest that the enduring personality variable attachment style, mediated by the level of structural integration of the personality, leads to higher stress and burnout experience. Affected students could be supported by early preventive measures enabling the sustainable preparation for this transitional period. Longitudinal prospective studies are needed to explore if the assumption is applicable that pre-existing vulnerabilities in school are exacerbated at this transitional stage.


Assuntos
Apego ao Objeto , Estresse Psicológico/psicologia , Estudantes de Medicina/psicologia , Esgotamento Profissional/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Personalidade , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
15.
Psychother Psychosom Med Psychol ; 66(1): 9-20, 2016 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-26581037

RESUMO

With a lifetime prevalence of about 17% depression is the most common mental disorder. Psychotherapy is efficacious in the treatment of depression, with no significant differences between different forms of psychotherapies. For psychodynamic therapy (PDT) various models proved to be efficacious in randomized controlled trials (RCTs). As a consequence the evidence for PDT is scattered between different forms or orientations of PDT entailing problems regarding psychotherapy training and the transfer of research into clinical practice. Thus, our aim was to develop a unified protocol for the dynamic treatment of depression that is based on those models of PDT that proved efficacious in randomized controlled trials (RCTs). As a first step we conducted a systematic search of RCTs investigating manualized or manual-based individual psychodynamic therapy for depressive disorders in adults that proved to be efficacious compared to comparison conditions. 11 studies fulfilled our inclusion criteria. In a second step we systematically reviewed the studies with regard to the treatment concepts they had applied. 7 highly consistent treatment components could be identified. We conceptualized them in the form of 7 interrelated treatment modules which constitute the unified psychodynamic protocol for depression. The protocol may enhance the empirical status of PDT and facilitate both psychotherapy training as well as the transfer of research to clinical practice. Through the focused use of techniques that proofed efficacious it is expected to bring more benefit to depressed patients and therefore also have a positive impact on the health care system.


Assuntos
Depressão/terapia , Medicina Baseada em Evidências , Psicoterapia Psicodinâmica/métodos , Depressão/psicologia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Humanos
16.
J Pers Disord ; 30(6): 776-795, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-26623534

RESUMO

The quality of depression in borderline personality disorder (BPD) was reported to differ from that in patients with major depressive disorder (MDD) only. However, little is known about affect dynamics in "borderline-depression." The authors assessed affective instability and reactivity in 20 MDD patients with BPD and in 21 MDD patients without BPD by Ambulatory Assessment. Participants reported on current affect, daily events, and attribution of affective states to events five times per day over a 7-day period. The results do not indicate higher affective instability in MDD patients with BPD comorbidity. Depressed patients with BPD reported less subjectively perceived affective reactivity, while observed associations between events and affect were not different between groups, except for one finding: In depressed patients with BPD, overall mood was lower after being alone. These findings suggest impaired attribution of mood changes and less tolerance of being alone as specific for depression in BPD.


Assuntos
Afeto , Transtorno da Personalidade Borderline/psicologia , Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Adulto , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/epidemiologia , Comorbidade , Depressão/epidemiologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Determinação da Personalidade/estatística & dados numéricos , Escalas de Graduação Psiquiátrica
17.
Z Psychosom Med Psychother ; 61(4): 327-41, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26646912

RESUMO

OBJECTIVES: The Inpatient and Day-Clinic Experience Scale (IDES) was developed to assess common factors in a multimodal psychotherapy setting from the patients' perspective. The questionnaire measures different aspects of therapeutic relationships, a positive self-view and a critical attitude towards therapy. METHODS: Three samples (total N = 821) were used to evaluate the psychometric properties and factor structure of the questionnaire. RESULTS: Confirmatory analyses show a good model fit and support the proposed structure with 25 items and seven scales. In addition, reliability indices were stable throughout multiple assessments over time. Concerning validity, early IDES process measures were moderately associated with symptomatic improvement. CONCLUSIONS: The IDES is a psychometrically reliable questionnaire for the evaluation of process factors in inpatient and day-clinic psychotherapy settings.


Assuntos
Hospital Dia/psicologia , Hospitalização , Transtornos Mentais/terapia , Satisfação do Paciente , Psicoterapia , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Terapia Combinada , Feminino , Alemanha , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Relações Médico-Paciente , Psicometria/estatística & dados numéricos , Processos Psicoterapêuticos , Reprodutibilidade dos Testes , Adulto Jovem
18.
Z Psychosom Med Psychother ; 61(3): 262-74, 2015.
Artigo em Alemão | MEDLINE | ID: mdl-26388057

RESUMO

OBJECTIVES: Screening for personality dysfunction is relevant to treatment planning in psychotherapy, psychosomatic medicine and psychiatry. This makes short versions of field-tested approaches such as the OPD Structure Questionnaire (OPD-SQ) necessary. METHODS: With the aim of developing a screening version, the original sample of the OPD-SQ was divided into two subsamples. After developing a preliminary 12-item version in one subsample, we used confirmatory factor-analysis in the second subsample as well as an independent sample to test the factor structure. RESULTS: The analyses confirmed a structure of three correlating factors with adequate fit indices. Other findings relating to the validity of the long version were replicated as well. In addition, data from an independent sample of psychotherapy inpatients confirmed the factor structure and provided further evidence for its validity. CONCLUSIONS: The OPD-SQS is a viable screening instrument for supporting clinical decision making in stepped-care approaches in psychotherapy, psychosomatic medicine and psychiatry.


Assuntos
Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Teoria Psicanalítica , Inquéritos e Questionários , Adulto , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Transtornos da Personalidade/terapia , Terapia Psicanalítica , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes
19.
Psychother Psychosom Med Psychol ; 65(7): 261-7, 2015 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-25927239

RESUMO

Depressions are frequent disorders in psychosomatic medicine and psychotherapy. However, there are only few controlled studies comparing different levels of care for depressed patients. Especially the efficacy of day-clinic psychotherapy for depression remains understudied. The pilot study aims to close this gap by examining the feasibility of a randomized-controlled trial comparing day-clinic and inpatient psychotherapy for depression in a routine hospital setting. The current paper adds the secondary outcome measures on patient self-reported symptoms and interpersonal problems. In addition, findings of a 6-month follow-up are analyzed. Overall, 44 patients were recruited and randomly allocated to either day clinic or inpatient psychotherapy for 8 weeks. Depressive symptoms and interpersonal problems decreased during treatment, and follow-up scores stayed below intake scores. There were no differences between the treatment groups in this pilot study. For the future, it is desirable to compare randomized patients with those patients who received their preferred treatment option. Although the findings need to be replicated in larger samples, they appear promising for day-clinic psychotherapy. The better understanding of differential effectiveness of different levels of care of patient subgroups remains an important goal.


Assuntos
Hospital Dia , Transtorno Depressivo Maior/terapia , Psicoterapia/métodos , Adolescente , Adulto , Antidepressivos/uso terapêutico , Terapia Combinada , Feminino , Seguimentos , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Projetos Piloto , Resultado do Tratamento , Adulto Jovem
20.
Z Psychosom Med Psychother ; 61(1): 19-35, 2015.
Artigo em Alemão | MEDLINE | ID: mdl-25831982

RESUMO

OBJECTIVES: While the general effectiveness of psychodynamic psychotherapy in both outpatient and inpatient treatment has been proven, few studies document the effectiveness of clinical inpatient treatment of depression through psychodynamic psychotherapy. METHODS: This paper presents first results of a naturalistic multicenter intervention study. Included were female inpatients suffering from depressive symptoms who had been admitted to 15 psychodynamically oriented psychosomatic hospital units (N = 487). The mean duration of treatment was 61.8 days. Data were acquired at admission (T1) and discharge (T2). RESULTS: Our findings support previous evidence and show that psychodynamically oriented inpatient psychotherapy of depressive disorders is efficient. High pre-post effect sizes were documented in all psychometric instruments used (BDI, HAM-D, SCL-90-R, BSS, GAF). Initial subgroup comparisons reveal that the benefits for patients with comorbid personality disorder are significantly lower than for depressed patients without comorbid personality disorder. CONCLUSION: Psychodynamic inpatient psychotherapy, as practiced under naturalistic conditions, is an effective treatment of depression. Predictors of therapeutic effects within different therapeutic settings, however, remain unclear. The sustainability of the therapeutic effects found and their impact on psychodynamic relevant constructs have still to be proven.


Assuntos
Transtorno Depressivo/terapia , Hospitalização , Psicoterapia Psicodinâmica/métodos , Adulto , Antidepressivos/efeitos adversos , Antidepressivos/uso terapêutico , Terapia Combinada , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Alemanha , Humanos , Pessoa de Meia-Idade , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Transtornos da Personalidade/terapia , Inventário de Personalidade , Transtornos Psicofisiológicos/diagnóstico , Transtornos Psicofisiológicos/psicologia , Transtornos Psicofisiológicos/terapia , Resultado do Tratamento
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