Nikendei Christoph, Mölle Christian, Fischer Kai, Granov Medzina, Huber Julia, Dinger Ulrike, Herzog Wolfgang, Schauenburg Henning, Ehrenthal Johannes C
Zentrum für Psychosoziale Medizin der Universität Heidelberg Klinik für Allgemeine Innere Medizin und Psychosomatik Thibautstrasse 4 D-69115 Heidelberg Deutschland Zentrum für Psychosoziale Medizin der Universität Heidelberg.
Institut für Medizinische Psychologie am Zentrum für Psychosoziale Medizin der Universität Heidelberg Deutschland Universitätsklinikum Heidelberg Zentrum für Psychosoziale Medizin: Institut für Medizinische Psychologie.
Z Psychosom Med Psychother. 2020 Jun;66(2):178-192. doi: 10.13109/zptm.2020.66.2.178.
Outpatient psychotherapy is a key element in the effective treatment of mental health problems. First results suggest that interpersonal problems lead to difficulties in receiving outpatient psychotherapeutic treatment. The relationship between these difficulties, attachment style, and the level of personality functioning is still unclear. We invited 1011 patients of a psychosomatic-psychotherapeutic university outpatient clinic to participate in the study. The clinical diagnoses according to ICD-10, as well as symptoms of depression (PHQ-D), and quality of life (SF-36) were recorded. Hypothesized predictors for the successful referral to outpatient therapy were patient age, availability of local outpatient treatment, number of ICD-10 diagnoses, the motivation for psychotherapy (FPTM), fear of stigmatization (Stig-9), level of personality functioning (OPD-SQ), and attachment style (ECR-RD). We were able to catamnestically reassess n = 300 patients (67.3 % of patients initially referred to outpatient therapy). A smaller number of clinical diagnoses, greater availability of psychotherapeutic care and higher therapy motivation, as well as a lower level of personality functioning predicted the successful referral to outpatient psychotherapy, while the combination of impaired personality functioning and avoidant attachment style was a negative predictor. Contrary to expectations, patients with a lower level of personality functioning are more successful in receiving outpatient psychotherapy. However, patients with a combination of impaired personality functioning and a high degree of attachment avoidance run the risk of not asserting their need for treatment.
门诊心理治疗是有效治疗心理健康问题的关键要素。初步结果表明，人际关系问题会导致在接受门诊心理治疗时出现困难。这些困难、依恋风格和人格功能水平之间的关系仍不明确。我们邀请了一所身心-心理治疗大学门诊诊所的1011名患者参与该研究。记录了根据国际疾病分类第10版（ICD-10）做出的临床诊断、抑郁症状（患者健康问卷抑郁量表，PHQ-D）和生活质量（简短健康调查量表，SF-36）。假设的成功转诊至门诊治疗的预测因素包括患者年龄、当地门诊治疗的可及性、ICD-10诊断数量、心理治疗动机（FPTM）、对污名化的恐惧（Stig-9）、人格功能水平（OPD-SQ）和依恋风格（亲密关系经历问卷修订版，ECR-RD）。我们能够对n = 300名患者进行随访重新评估（占最初转诊至门诊治疗患者的67.3%）。临床诊断数量较少、心理治疗护理的可及性较高、治疗动机较强以及人格功能水平较低可预测成功转诊至门诊心理治疗，而人格功能受损与回避型依恋风格的组合是一个负面预测因素。与预期相反，人格功能水平较低的患者在接受门诊心理治疗方面更成功。然而，人格功能受损与高度依恋回避相结合的患者有无法坚持其治疗需求的风险。
