Dimensions of the operationalized psychodynamic diagnosis system that predict long-term outcome after inpatient psychotherapy.

BACKGROUND/AIMS: To determine whether the Operationalized Psychodynamic Diagnosis (OPD) system can be useful in predicting patient outcome in the long term.

METHODS

OPD was assessed by the therapists prior to and after inpatient treatment. Patients completed psychometric scales at the start and completion of psychosomatic-psychotherapeutic inpatient treatment and at the follow-up. Outcome was defined by the general factor emerging from a principal component analysis of the Brief Symptom Inventory, Hospital Anxiety and Depression Scale and Inventory of Interpersonal Problems at katamnesis, representing individual differences in general distress.

RESULTS

Several dimensions of the OPD system proved to be predictors of general distress at the follow-up in 253 former inpatients. Negative predictors of long-term outcome were the high internal impediments to change, namely high secondary gains from illness and also less integrated structural abilities. Positive OPD predictors of long-term outcome were the treatment success achieved at the end of inpatient psychotherapy in changing the illness concept towards a psychological understanding of symptoms, lower levels of complaints and a higher functional level. Also the achieved level of awareness for the individual maladaptive behavioral pattern is predictive of a favorable long-term outcome.

CONCLUSIONS

The results provide evidence for the clinical relevance and the predictive value of OPD. © 2014 S. Karger AG, Basel.