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

Abstract

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.

Personality systems interactions theory: an integrative framework complementing the study of the motivational and volitional dynamics underlying adjustment to chronic pain

“…The respective self-report instrument, the DSM–5 Levels of Personality Functioning Scale, has good psychometric qualities ( 171 ). Interestingly, the Operationalized Psychodynamic Diagnosis System (OPD) defines similar psychological capacities necessary for adaptive personality functioning, such as self-awareness and affect regulation ( 173 ). A 12-item short version (OPD-SQS) has recently been published ( 170 ).…”

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

“…The psychosomatic ward with 14 beds comprises two treatment units, one for patients with eating disorders and the other for patients with other psychiatric and psychosomatic disorders. Patients receive multimodal high-dose inpatient psychotherapy (as described by Dinger et al 2014, Schneider et al 2015, which is well established in Germany. It comprises 2 to 3 50-minute individual psychodynamic therapy sessions a week, two 50-minute sessions of interactional psychodynamic group therapy, two sessions of concentrative movement therapy and art therapy (75 minutes/session each); additionally, there are ward rounds, progressive muscle relaxation (PMR), sports; all these are complemented with disorder-specific procedures where indicated (psychoeducation, exposure training, symptom diaries, stabilization techniques, trauma exposure techniques, and physiotherapy, among others), medical treatments and medication as required.…”