Long-term outcomes of short-term and long-term psychosomatic inpatient treatment and their predictors

Schaefer, Anke; Gieler, Uwe; Kurth, Regina A.; Brosig, Burkhard; Leweke, Frank; Milch, Wolfgang; Reimer, Christian; Beutel, Manfred E.

doi:10.1016/j.jpsychores.2008.06.003

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Women constituted 72% of our sample, men only 28%. Other authors have also described a higher percentage of women receiving inpatient psychotherapy (Kirchmann et al 2009;Schaefer et al 2008;Schadeberg 2000). This may be due partly to the higher prevalence of the mental disorders treated in this setting (anxiety; depression; eating disorders; somatoform and dissociative disorders) in women Wittchen 2011;Meyer 2000).…”

Section: Discussionmentioning

confidence: 97%

Operationalized Psychodynamic Diagnosis System and Outcome of Psychodynamic Inpatient Psychotherapy in Male and Female Patients

Schneider

Heuft

2018

Zeitschrift für Psychosomatische Medizin und Psychotherapie

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Objective: To compare male and female patients with regard to the Operationalized Psychodynamic Diagnosis (OPD-2) system, treatment variables, and outcome after multimodal psychodynamic inpatient psychotherapy. Methods: At the beginning and at the end of inpatient treatment in a multimodal psychodynamic setting, patients were examined with the OPD-2 system as well as with three self-assessment questionnaires addressing interpersonal problems (Inventory of Interpersonal Problems, IIP), and psychopathology: Brief Symptom Inventory (BSI) and the Hospital Anxiety and Depression Scale (HADS). Results: Data of 850 patients (238 males, 28%), 612 females, 72%) were available for analysis. There were differences between men and women in the main diagnoses, with a higher proportion of eating disorders and a longer treatment duration among the women. Therapy discontinuation rates were low and did not differ between the sexes. Women scored higher on psychopathology at admission on the BSI Global Score, IIP and anxiety; the pattern of reported interpersonal problems was consistent with sex roles. While the level of structural integration was similar in both sexes, the distribution of the two main conflicts and the level of improvement of awareness and dealing with the psychodynamic foci showed significant differences. Overall, at the end of inpatient psychotherapy, there was a mean improvement in both men and women, with no significant differences between them. Because of higher scores at the start of psychotherapy, the effect sizes for improvement were higher for women. Conclusions: On the whole, both sexes seem to benefit equally from psychodynamic inpatient psychotherapy in terms of symptom improvement.

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Section: Discussionmentioning

confidence: 97%

Operationalized Psychodynamic Diagnosis System and Outcome of Psychodynamic Inpatient Psychotherapy in Male and Female Patients

Schneider

Heuft

2018

Zeitschrift für Psychosomatische Medizin und Psychotherapie

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“…In older depressive patients, comorbidity with personality disorders was a negative predictor of outcome in the 6- to 8-year follow-up [50]. Infantile object relationships and interpersonal problems were negative predictors of outcome in the 3-year follow-up in a mixed sample of psychotherapy patients [11]; the same was true of a compulsive and depressive personality structure [42]. A secure bonding style showed a moderate association with a better outcome at the end of inpatient psychotherapy [51].…”

Section: Discussionmentioning

confidence: 99%

“…Inpatient psychotherapy is recommended if the patient's condition is very severe, if there is substantial somatic or psychic comorbidity, in prolonged sick leave, if the patients have no motivation for outpatient psychotherapy because of somatic illness concepts or if outpatient psychotherapy does not succeed in alleviating the patient's complaints. Several studies have demonstrated that the patients may derive substantial benefit in terms of improvement in global psychological and physical stress and complaints, subjective health assessment and interpersonal problems [1,2,3,4,5,6,7,8,9,10,11]. Follow-up studies have shown that these improvements are maintained over a period of time (1-year follow-up [1,2,3,4,6,9]; 3- and 3- to 5-year follow-up [7,11]).…”

Section: Introductionmentioning

confidence: 99%

Dimensions of the Operationalized Psychodynamic Diagnosis System that Predict Long-Term Outcome after Inpatient Psychotherapy

Schneider¹,

Tiemann²,

Stumpf³

et al. 2014

Psychopathology

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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.

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“…Additionally it is also of interest whether the health status of patients can still be improved. There are several studies on positive effects with respect to improvement of the medical and psychological status of patients, their social impairment, the motivation to work, the number of days on sickness absence, reduction of early retirement and occupational reintegration [59,60,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80]. An important outcome parameter is that the system saves money for the pension insurance.…”

Section: Quality Assurance Effectiveness and The International Perspmentioning

confidence: 99%

“…The pension insurance agency has a direct financial benefit when patients stay at work for only 3 additional months. A proof for the effectiveness of psychosomatic rehabilitation is that the pension insurance agency, which has all pertinent data, has continuously implemented more and more rehabilitation facilities over the years [20,76,77,78,79]. …”

Section: Quality Assurance Effectiveness and The International Perspmentioning

confidence: 99%

Psychosomatic Inpatient Rehabilitation: The German Model

Lindén¹

2014

Psychother Psychosom

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The term ‘psychosomatic' has many connotations, be it in the sense of a general biopsychosocial concept in medicine as outlined in the ICF (International Classification of Functioning, Disability and Health) of the World Health Organization, a holistic and person-centered view of the patient beyond the illness, the treatment of somatoform or somatic disorders, or special psychotherapeutic approaches. In Germany, there are also about 25,000 inpatient beds in ‘psychosomatic rehabilitation hospitals', which treat approximately 5/1,000 inhabitants in the working age population per year. These institutions give an example of how to translate the theoretical concepts of psychosomatic medicine and of the ICF into clinical practice. ‘Psychosomatic rehabilitation' aims at the prevention, treatment and compensation of chronic illness by a biopsychosocial approach. This includes a multilevel psychosomatic assessment and a multidimensional treatment focus including the reduction of symptoms, the training of capacities, the coping with chronic illness and impairment, the restoration of well-being and normal life, and the occupational reintegration including the search for a workplace, which allows work in spite of impairment. Scientific studies have shown that the psychological status, the motivation to work, the number of days on sickness leave and occupational reintegration can be improved, and that the system pays for the patients themselves, but also pension and health insurance companies.

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Long-term outcomes of short-term and long-term psychosomatic inpatient treatment and their predictors

Cited by 5 publications

References 13 publications

Operationalized Psychodynamic Diagnosis System and Outcome of Psychodynamic Inpatient Psychotherapy in Male and Female Patients

Operationalized Psychodynamic Diagnosis System and Outcome of Psychodynamic Inpatient Psychotherapy in Male and Female Patients

Dimensions of the Operationalized Psychodynamic Diagnosis System that Predict Long-Term Outcome after Inpatient Psychotherapy

Psychosomatic Inpatient Rehabilitation: The German Model

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