Course of self-reported symptoms of 342 outpatients receiving medium- versus long-term psychodynamic psychotherapy

Abstract

BackgroundThe course of self-reported symptoms during medium- versus long-term psychodynamic psychotherapy has rarely been documented for outpatient settings. This observational study describes routine practice of ambulatory treatment in Germany and explores self-reported symptoms of a broad patient sample undergoing one (medium-term) versus two years (long-term) of psychodynamic psychotherapy.MethodsOver four and a half years, longitudinal self-report symptom data were collected from 342 outpatients as part of a standardized documentation system. Self-report data were compared between patients receiving either medium-term or long-term psychodynamic psychotherapy.ResultsRoutine care significantly decreased disease burden as reported by patients by small to medium effect sizes (ES) for depression (ES = 0.58), anxiety (ES = 0.49), obsessive-compulsive disorder (ES = 0.54), somatoform disorder (ES = 0.32), eating disorder (ES = 0.38). The majority of patients completed treatment after one year and showed medium-size changes. For a subgroup of patients with depressive and/or obsessive-compulsive disorder symptoms for whom two years of therapy were deemed necessary, additional benefits were reported during the second year of treatment (ES = 0.61 and ES 0.47, respectively).ConclusionsOur findings suggest that both medium- and long-term psychodynamic psychotherapy decrease self-reported disease burden of patients with depression, anxiety, obsessive-compulsive, somatoform and/or eating disorders. For a subgroup of patients, additional benefits were gained in the second year of treatment.

Psychobehavioural B-criteria of somatic symptom disorder are associated with somatic symptom reporting in a large sample of psychosomatic outpatients

“…Compared with the German population census [25], patients in our clinical sample were more often female (62.4% vs. 51.0%), lived in a partnership (53.5 vs. 43.0%), did not have German citizenship (15.4% vs. 12.5%), and were younger age (38.4 vs. 44.5 years). The rate of 35.7% of participants receiving unemployment benefits is rather high compared to other samples of psychosomatic outpatients in Berlin (14%; [26]) and psychosomatic inpatients all over Germany (19.6%; [27]). We observed a high overall mental symptom load in our patient sample.…”

Clinical Recommendations for Addressing Impasses in Long-Term Psychotherapy

“…Long-term psychotherapy may be especially helpful for personality and interpersonal issues [1][2][3] psychological distress in the context of enduring psychosocial problems and chronic physical illness [4], disorders with high rates of relapse [5], and personal growth [6]. Additionally, patients diagnosed with a psychotic disorder typically require long-term care.…”