Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie最新文献

The role of schemas is well established in personality disorders. Their influence on therapy outcome of patients with Axis I disorders remains unclear. Therefore, patients with a panic disorder (PD) with/without agoraphobia varying in their expression of early maladaptive schemas were examined regarding therapy outcomes after exposure therapy. In this study, a sample of 216 patients with panic disorder with/without agoraphobia were recruited in a day clinic. After the initial diagnosis with the Structured Clinical Interview, the patients filled out the Young Schema Questionnaire (YSQ-S2), Beck Depression Inventory and Revised Symptom Checklist. Afterwards, they participated in a five-week manualized exposure therapy by Lang et al. (2011). Subjects with high schema scores showed lower therapeutic success rates than subjects with a weaker pattern score. In addition, it was found that high schema levels, especially of schemas regarding impaired autonomy and achievement (YSQ-S2: domain 2), influenced therapy outcome by either predicting more/severe or less/milder anxiety-, phobicrelated and general symptoms after therapy. The results of this study emphasize the role of schemas not only for personality disorders but also for disorders on Axis I. For PD with/without agoraphobia, schemas regarding impaired autonomy and achievement seem to play the most important role regarding the influence on therapy outcome.

Patient characteristics at a psychodynamic training institute Outpatient clinics affiliated with psychotherapeutic training institutions play a crucial role in ensuring the quality of future psychotherapists' training.

Objective: In the present study we examined the characteristics of patients in terms of symptomatology and psychodynamic dimensions.

Methods: The study utilized online questionnaires completed by n = 421 patients between September 2020 and March 2021. These questionnaires gathered information on sociodemographics, symptomatology (PHQ-D), relationship dynamics (IIP), personality functioning (OPD-SQS, IPO-16), and intrapsychic conflicts (OPD-KF).

Results: The sample consisted of 71.0 % females, with 65 % having prior experience with psychotherapeutic treatments. Notably, 74.9 % of the patients fulfilled the criteria of a depressive disorder in PHQ-D (with 34.8 % identified as Major Depressive Disorder, MDD). Additionally, 53.1 % of all patients surpassed the threshold for the diagnosis of a personality disorder based on the IPO-16.

Discussion: Findings suggest that patients seeking treatment at these clinics exhibit significant psychological distress and often have a history of prior psychotherapeutic interventions.

Loads and limits for outpatient psychotherapists after the reform Objectives: The reform of the psychotherapy directive in 2017 challenged psychotherapists by new obligations and processes. We investigated burdens psychotherapists experience due to the reform and differences concerning urban vs. rural region, half vs. full care license and psychotherapy method.

Methods: Of 128 psychotherapists approached, 41 (32 %) agreed to study participation. Semistructured interviews were examined via qualitative content analysis.

Results: 83 % (n = 34) expressed some kind of burden. Burdens in terms of time, pressure/ stress and having to decline patients were named most frequently. 54 % of the participants (n = 22) pointed out various limits to what they can accomplish, mostly related to shortened waiting times and treatment availability. Burdens were more common among psychotherapists with a half care license and behavioural therapy; there were no major differences between urban or rural residents.

Discussion: Burdens for psychotherapists may result from individual life situations and resources of treatment availability.

Changes in conflict pathology during inpatient psychotherapy and their relationship with symptom reduction Background: In psychodynamic psychotherapy, the treatment of a patient's unconscious conflicts represents an essential aspect of psychotherapeutic success. The present study therefore investigated whether 1) the significance of conflict issues changes during inpatient psychodynamic psychotherapy, and whether 2) greater changes in the significance of conflicts are associated with a greater reduction in symptoms.

Method: 113 patients provided information on their symptoms (BSI-18) and the significance of six OPD conflict themes in active and passive mode (12 conflict scales) by self-report on admission and discharge. Using Welch's t-tests and multiple regression models, both pre-post changes in symptoms and conflict significance and the influence of conflict changes on symptom reduction were analyzed.

Results: Four OPD conflict scales changed significantly during treatment. Patients who changed more strongly in terms of the manifestation of conflicts also showed a greater reduction in symptoms.

Discussion: The results indicate both a certain stability of conflict issues and their changeability and confirm the psychodynamic theory that change in conflict issues is associated with symptom reduction.