Elfrida Hartveit Kvarstein1,2, Ola Nordviste3, Lone Dragland4, Theresa Wilberg2,5. 1. Section for Personality Psychiatry, Clinic for Mental Health and Addiction, Oslo University Hospital, Norway. 2. Institute for Clinical Medicine, University of Oslo, Norway. 3. Student Health Service, Student Welfare Organization Oslo/Akershus, Norway. 4. Diakonhjemmet Hospital, Oslo, Norway. 5. Department for Research and Development, Clinic for Mental Health and Addiction, Oslo University Hospital, Norway.
Abstract
OBJECTIVES: Outpatient group psychotherapy is frequent within specialist services, recruits a mixed population, but effects are poorly documented. This study investigates long-term outcomes for patients with personality disorder (PD) treated in outpatient, psychodynamic groups within secondary mental health service. METHODS: A naturalistic study (N = 103) with repeated assessments of process and clinical outcomes. Longitudinal statistics are linear mixed models. RESULTS: The main PDs were avoidant, borderline and NOS PD, mean number of PDs 1.4(SD0.7), 60% females and mean initial age 38(SD10) years. Mean treatment duration was 1.5(SD 0.9) years. Therapist alliance and experienced group climate was satisfactory and stable. Improvements were significant (symptom distress, interpersonal problems, occupational functioning and additional mental health services), irrespective of general PD-severity, but not of PD-type, age or gender. The study demonstrates PD NOS benefits across all outcomes, occupational improvements for avoidant PD, despite prevailing symptoms, but generally poorer outcomes for males and age >38 years. For borderline PD, experienced conflict was stronger, treatment duration shorter and outcomes poor for early drop-outs (28%). CONCLUSION: Psychodynamic group psychotherapy is a recommendable treatment for moderate PDs, which may address avoidant strategies, but may not meet clinical challenges of borderline PD. The outcome differences related to gender and age are noteworthy.
OBJECTIVES:Outpatient group psychotherapy is frequent within specialist services, recruits a mixed population, but effects are poorly documented. This study investigates long-term outcomes for patients with personality disorder (PD) treated in outpatient, psychodynamic groups within secondary mental health service. METHODS: A naturalistic study (N = 103) with repeated assessments of process and clinical outcomes. Longitudinal statistics are linear mixed models. RESULTS: The main PDs were avoidant, borderline and NOS PD, mean number of PDs 1.4(SD0.7), 60% females and mean initial age 38(SD10) years. Mean treatment duration was 1.5(SD 0.9) years. Therapist alliance and experienced group climate was satisfactory and stable. Improvements were significant (symptom distress, interpersonal problems, occupational functioning and additional mental health services), irrespective of general PD-severity, but not of PD-type, age or gender. The study demonstrates PD NOS benefits across all outcomes, occupational improvements for avoidant PD, despite prevailing symptoms, but generally poorer outcomes for males and age >38 years. For borderline PD, experienced conflict was stronger, treatment duration shorter and outcomes poor for early drop-outs (28%). CONCLUSION: Psychodynamic group psychotherapy is a recommendable treatment for moderate PDs, which may address avoidant strategies, but may not meet clinical challenges of borderline PD. The outcome differences related to gender and age are noteworthy.
Authors: Sarah Ledden; Luke Sheridan Rains; Merle Schlief; Phoebe Barnett; Brian Chi Fung Ching; Brendan Hallam; Mia Maria Günak; Thomas Steare; Jennie Parker; Sarah Labovitch; Sian Oram; Steve Pilling; Sonia Johnson Journal: BMC Psychiatry Date: 2022-09-05 Impact factor: 4.144