Zeitschrift Fur Psychosomatische Medizin Und Psychotherapie最新文献

Emotional experience and change in psychodynamic inpatient psychotherapy Objectives: The subject of the present study is the recording of emotional experience and its change through inpatient psychodynamic psychotherapy, taking into account the factors of age, gender, and traumatic experiences in childhood and adolescence. Methods: The following standardized instruments were used on the clinical sample of 971 patients (413 inpatient, 558 day clinic patients) at the beginning and at the end of the treatment: Questionnaire for the Assessment of Emotional Experience and Emotion Regulation (EER), Childhood-Trauma-Questionnaire (CTQ), Inventory of Interpersonal Problems (IIP), Helping Alliance Questionnaire (HAQ), Symptom-Check-List (SCL-90-R). Results: The mean duration of treatment was 66.8 days (SD = 14.1; range 30-96). Younger patients and polytraumatized patients showed a higher expression of negative emotions. At the end of treatment, the whole group of patients showed a change in emotional experience, especially a strong decrease in passive-negative emotions and a decrease in psychological distress. Age represented a significant factor influencing emotional change. Discussion: The results underline the importance of emotional change as a prerequisite for treatment success and confirm the effectiveness of inpatient psychodynamic treatment. A further differentiation of the patients with regard to their emotional responsiveness seems to make sense with regard to the suitability of the therapeutic offers.

Pilot study examining a profession-oriented rehabilitation concept for nursing professions Objectives: Nursing professions are associated with high levels of psychological distress, high numbers of absent days and premature retirement. To achieve higher return-to-work rates, psychosomatic rehabilitation is expected to offer treatments tailored to workplace demands. This pilot study is the first to examine the effects of a new workplace-oriented medical rehabilitation program for nursing professions. Methods: A total of N = 145 depressed patients in nursing occupations (86.9 % female; 50.9 ± 7.34 years) took part in a workplace-oriented rehabilitation program for nursing professions. At admission they were compared to N = 147 depressed patients (63.27 % female; 49.36 ± 7.58 years) in non-nursing professions regarding patterns of work-related experience and behaviour (AVEM) using a MANOVA with follow-up ANOVAs for individual subscales. Changes in work-related attitudes among the nursing professions following completion of the intervention were assessed using a MANOVA followed by repeated measures ANOVAs. The effect of the workplace- oriented intervention on depressiveness (BDI-II) was compared to a treatment program for depression using a mixed model after taking potentially confounding variables into account. Results: At entry, depressed patients in nursing professions scored significantly higher on AVEM scale willingness to work to exhaustion and lower on AVEM scale distancing ability compared to depressed patients in other professions. Following completion of the workplace-oriented intervention program for nursing professions, participants showed a significant reduction on AVEM scales subjective importance of work, willingness to work to exhaustion, and striving for perfection. Increasing scores were observed on the distancing ability and life satisfaction scales. Depression scores had significantly improved at discharge in both participants of the work-oriented intervention and the disorder-specific intervention for depressive disorders, whereas neither group differences nor interaction effects were found. Conclusions: The work-oriented intervention for nursing professions successfully induced changes in maladaptive work-related attitudes. Improvements in depressiveness did not significantly differ from an intervention targeting depression specifically.

Objectives: In different therapeutic approaches, insight is acknowledged as an important part of patient's therapeutic change process. We examined whether the level of insight (1) differs between psychoanalytic (PA), psychodynamic (PD) and cognitive-behavioral therapy (CBT), and (2) predicts long-term symptomatic outcome. Methods: A completer sample of 67 depressed patients from the Munich Psychotherapy Study was analyzed. Symptoms were assessed with Beck Depression Inventory (BDI) and Symptom Checklist-Revised (SCL-90-R) at pre-treatment and three-year follow-up. Insight was assessed from 242 sessions of mid-therapy phase with the Experiencing Scale. Results: The general level of insight was higher in PA as compared to CBT, and associated with lower depressive symptoms (BDI) across all three therapeutic modalities at three-year follow-up. Insight was unrelated to general distress (SCL-90-R). Exploratory analyses suggested that patients treated with PA showed higher levels of insight especially in high quality sessions (assessed by therapist). Patients for whom the extent of insight was positively linked to session quality, suffered from more depressive symptoms at three-year follow-up than patients gaining insight when session quality was low. Conclusion: Insight differs between PA and CBT and may be a common change mechanism in long-term psychotherapies.

Objective: While comorbidity of different forms of cancer and clinical depression is reported for many single studies, representative and global overviews are scarce. Methods: A systematic review was carried out (mainly based on Medline, Embase, Cochrane, PsychLit, and Psyndex) to identify studies in adult cancer patients from 2007 to 2019. Studies with noncancer populations and cancer survivors were excluded. Assessment methods of depression were chart-based diagnoses, interview-based and self-report questionnaires. Quality and plausibility were checked using the adapted Downs & Black checklist. Results: For all 210 included studies the prevalence rate of clinical depression varied from 7.9 % to 32.4 %, with a mean of 21.2 % depression for different (mixed) cancer entities. The different methods of assessment have led to under- (especially charts-based diagnoses) as well as overreporting for some forms of cancer. In general, the different assessment forms show an acceptable variation in prevalence. Conclusions: The risk for a cancer patient to suffer a clinical depression during the first year after diagnoses is 15 % to 20 %, meaning every fifth or sixth patients. Different cancer entities, stage of cancer and treatments as well as different cultural and medical backgrounds show only slight variation in prevalence rates.