Effective Care of Treatment-Resistant Patients in an ISTDP-Based In-Patient Treatment Program

Symptom- and personality disorder changes in intensive short-term dynamic residential treatment for treatment-resistant anxiety and depressive disorders

“…Based on these figures, it would seem that the ISTDP-based, time-limited, residential treatment programme is an approach that warrants consideration for patients who do not respond to standard treatment formats. This study thereby supports the conclusions drawn in two previous studies of the treatment programme (2,9) and extends our knowledge base by adding information on observer-based diagnostic changes, along with information on psychosocial changes and changes in use of psychotropic medications. In all assessment domains of the present study, results point in the same direction: high-intensity, residential treatment tailored to the needs of treatment-resistant patients appears both highly effective and efficacious.…”

“…Details of the treatment programme are extensively described elsewhere and can be accessed there for interested readers (2,9,10). A summary is presented here.…”

“…Despite the proven efficacy and effectiveness of psychiatric and psychotherapeutic treatments for mental disorders, a large proportion of patients remains who do not benefit from the treatments they are provided (1,2). Only about one half of treated patients in well-designed clinical trials can be expected to recover in terms of symptomatic levels.…”

“…There are also recent studies indicating that high-intensity and relatively short-term residential treatment may be highly effective for treatment-resistant populations. For example, Stålseth et al (8) and Solbakken and Abbass (2,9,10) have shown that intensive time-limited, residential treatments are effective in helping a large proportion of patients with known treatment-resistant depressive- and anxiety disorders. Stålseth et al demonstrated that a tailored psychodynamic existential 12-week treatment programme for patients with treatment-resistant depression and comorbid Cluster C personality disorder was superior to residential treatment as usual (TAU) of identical length with matched controls.…”

“…The present study addresses these issues and thus builds on existing research on the effectiveness of customised, intensive residential treatment for patients with treatment-resistant disorders. It reports changes in observer-based diagnostic status (including presence of Axis I and II disorders, the level of Axis I comorbidity, and overall Axis II severity), along with changes in medication use, health care utilisation, and employment status during and after the intensive time-limited residential treatment programme for patients with repeated non-response to psychiatric treatment as described in Solbakken and Abbass (2,10). The present study sample is comprised of all patients included in the previous two outcome studies from that programme.…”