The interplay of personality pathology and treatment outcome in psychosomatic psychotherapy: A longitudinal analysis using latent change score modelling.

Autor:	Bierling AL; Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307 Dresden, Germany; Department of Clinical Psychology, Institute of Psychology, Friedrich-Schiller University Jena, Am Steiger 3-1, 07743 Jena, Germany. Electronic address: Antonie.bierling@uni-jena.de., Doering S; Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria., Weidner K; Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307 Dresden, Germany., Pape M; Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany; University of Bamberg, Department of Clinical Psychology and Psychotherapy, Bamberg, Germany., Kessler H; Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany; Department of Psychosomatic Medicine and Psychotherapy, Campus Fulda, University of Marburg, Fulda, Germany., Hofmann T; Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine and Psychotherapy, DRK Kliniken Berlin Wiegmann Klinik, Berlin, Germany., Rose M; Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany., Imbierowicz K; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University of Bonn, Bonn, Germany., Geiser F; Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University of Bonn, Bonn, Germany., Rademacher J; Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany., Michalek S; Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany., Morawa E; Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany., Erim Y; Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany., Schneider JS; Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany., Teufel M; Clinic of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany., Hartmann A; Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany., Lahmann C; Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany., Peters EMJ; Charité Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Giessen, Germany., Kruse J; Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University of Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, Philipps-University of Marburg, Marburg, Germany., von Boetticher D; Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany., Herrmann-Lingen C; Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany., Nöhre M; Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany., de Zwaan M; Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany., Dinger U; Department of Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany., Friederich HC; Department of General Internal Medicine and Psychosomatics, University Hospital, Heidelberg University, Heidelberg, Germany., Niecke A; Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany., Albus C; Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany., Zwerenz R; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany., Beutel M; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany., Sattel HC; Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany., Henningsen P; Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Munich, Germany., Stein B; Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany., Waller C; Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany., Hake K; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany., Spitzer C; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany., Stengel A; Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany; German Center for Mental Health, Site Tübingen, Tübingen, Germany; Clinic for Psychosomatic Medicine and Psychotherapy, Klinikum Stuttgart, Stuttgart, Germany., Zipfel S; Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany; German Center for Mental Health, Site Tübingen, Tübingen, Germany., Weimer K; Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany., Gündel H; Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany., Herpertz S; Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany., Croy I; Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307 Dresden, Germany; Department of Clinical Psychology, Institute of Psychology, Friedrich-Schiller University Jena, Am Steiger 3-1, 07743 Jena, Germany; German Center for Mental Health (DZPG), Site Halle-Jena-Marburg, Germany.
Jazyk:	angličtina
Zdroj:	Comprehensive psychiatry [Compr Psychiatry] 2024 Nov; Vol. 135, pp. 152532. Date of Electronic Publication: 2024 Sep 23.
DOI:	10.1016/j.comppsych.2024.152532
Abstrakt:	Introduction: While ample data demonstrate the effectiveness of inpatient psychosomatic treatment, clinical observation and empirical evidence demonstrate that not all patients benefit equally from established therapeutic methods. Especially patients with a comorbid personality disorder often show reduced therapeutic success compared to other patient groups. Due to the heterogeneous and categorical personality assessment, previous studies indicated no uniform direction of this influence. This complicates the derivation of therapeutic recommendations for mental disorders with comorbid personality pathology. Methods: Analyzing n = 2094 patients from German university hospitals enrolled in the prospective "MEPP" study, we tested the dynamic interaction between dimensionally assessed personality functioning and psychopathology of anxiety and depression. Results: Longitudinal structural equation modelling replicated the finding that the severity of symptoms at admission predicts symptom improvement within the same symptom domain. In addition, we here report a significant coupling parameter between the baseline level of personality function and the change in general psychopathology - and vice versa. Discussion and Conclusion: These results imply that personality pathology at admission hinders the therapeutic improvement in anxiety and depression, and that improvement of personality pathology is hindered by general psychopathology. Furthermore, the covariance between both domains supports the assumption that personality functioning and general psychopathology cannot be clearly distinguished and adversely influence each other. A dimensional assessment of the personality pathology is therefore recommendable for psychotherapy research and targeted therapeutic treatment. Competing Interests: Declaration of competing interest Christoph Herrmann-Lingen reports financial support was provided by Hogrefe Publishing. Christoph Herrmann-Lingen reports financial support was provided by Novartis AG. All authors, except for Stephan Doering, are working at one of the German university departments of psychosomatic medicine and psychotherapy. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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