Spitzer Carsten, Michels-Lucht Felicitas, Siebel Ute, Freyberger Harald J
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ernst-Moritz-Arndt-Universität Greifswald im Klinikum der Hansestadt Stralsund, Rostocker Chaussee 70, 18437 Stralsund, Germany.
Z Psychosom Med Psychother. 2004;50(1):70-85. doi: 10.13109/zptm.2004.50.1.70.
To investigate the prognostic relevance of the axis "structure" of operationalized psychodynamic diagnostics (OPD) with respect to the symptom-related and interpersonal outcome of inpatient psychotherapy by applying group comparisons as well as individual criteria.
The structural level of 102 psychiatric inpatients was related to the general and dissociative psychopathology (SCL-90; FDS-20) as well as interpersonal problems (IIP) at the beginning and at the end of inpatient treatment.
There was a tendency toward an association between the structural level and psychopathological improvement. However, we did not find any clear relationship between structure and interpersonal difficulties either at the beginning or during the course of the treatment. The structural dimensions did not correlate with the reduction of psychopathology or interpersonal problems. From the patients perspective, however, overall personality structure, defence and object perception were important predictors for therapy success.
In correspondence with other studies our findings suggest that consistent predictions on therapy outcome in regards to psychopathology and interpersonal problems are not possible on the basis of the axis "structure". The possible implications for a differential therapy indication are discussed.
通过应用组间比较以及个体标准,研究操作性精神动力学诊断(OPD)的“结构”轴与住院心理治疗的症状相关及人际结果的预后相关性。
102名精神科住院患者的结构水平与住院治疗开始和结束时的一般及分离性精神病理学(SCL-90;FDS-20)以及人际问题(IIP)相关。
结构水平与精神病理学改善之间存在关联趋势。然而,我们在治疗开始时或治疗过程中均未发现结构与人际困难之间存在任何明确关系。结构维度与精神病理学或人际问题的减轻无关。然而,从患者角度来看,整体人格结构、防御和客体认知是治疗成功的重要预测因素。
与其他研究一致,我们的研究结果表明,基于“结构”轴无法对精神病理学和人际问题的治疗结果进行一致预测。讨论了其对差异化治疗指征的可能影响。