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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Antonie Louise Bierling - , Department of Psychotherapy and Psychosomatic Medicine, Friedrich Schiller University Jena (Author)
  • Stephan Doering - , Medical University of Vienna (Author)
  • Kerstin Weidner - , Department of Psychotherapy and Psychosomatic Medicine (Author)
  • Magdalena Pape - , Ruhr University Bochum, University of Bamberg (Author)
  • Henrik Kessler - , Ruhr University Bochum, University of Marburg (Author)
  • Tobias Hofmann - , Charité – Universitätsmedizin Berlin, German Red Cross (Author)
  • Matthias Rose - , Charité – Universitätsmedizin Berlin (Author)
  • Katrin Imbierowicz - , University of Bonn (Author)
  • Franziska Geiser - , University of Bonn (Author)
  • Jörg Rademacher - , University Hospital Duesseldorf (Author)
  • Silke Michalek - , University Hospital Duesseldorf (Author)
  • Eva Morawa - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Yesim Erim - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Johanna Sophie Schneider - , LVR University Hospital Essen, University of Duisburg-Essen (Author)
  • Martin Teufel - , LVR University Hospital Essen, University of Duisburg-Essen (Author)
  • Armin Hartmann - , University Medical Center Freiburg (Author)
  • Claas Lahmann - , University Medical Center Freiburg (Author)
  • Eva Milena Johanne Peters - , Charité – Universitätsmedizin Berlin, Justus Liebig University Giessen (Author)
  • Johannes Kruse - , Justus Liebig University Giessen, University of Marburg (Author)
  • Dirk von Boetticher - , University of Göttingen (Author)
  • Christoph Herrmann-Lingen - , University of Göttingen (Author)
  • Mariel Nöhre - , Hannover Medical School (MHH) (Author)
  • Martina de Zwaan - , Hannover Medical School (MHH) (Author)
  • Ulrike Dinger - , University Hospital Duesseldorf, Heidelberg University  (Author)
  • Hans Christoph Friederich - , Heidelberg University  (Author)
  • Alexander Niecke - , University of Cologne (Author)
  • Christian Albus - , University of Cologne (Author)
  • Rüdiger Zwerenz - , University Medical Center Mainz (Author)
  • Manfred Beutel - , University Medical Center Mainz (Author)
  • Heribert Christian Sattel - , Ludwig Maximilian University of Munich (Author)
  • Peter Henningsen - , Ludwig Maximilian University of Munich (Author)
  • Barbara Stein - , Paracelsus Medical University Nuremberg (Author)
  • Christiane Waller - , Paracelsus Medical University Nuremberg (Author)
  • Karsten Hake - , University of Rostock (Author)
  • Carsten Spitzer - , University of Rostock (Author)
  • Andreas Stengel - , University Hospital Tübingen, German Center for Mental Health (DZPG), Klinikum Stuttgart (Author)
  • Stephan Zipfel - , University Hospital Tübingen, German Center for Mental Health (DZPG) (Author)
  • Katja Weimer - , Ulm University (Author)
  • Harald Gündel - , Ulm University (Author)
  • Stephan Herpertz - , Ruhr University Bochum (Author)
  • Ilona Croy - , Department of Psychotherapy and Psychosomatic Medicine, Friedrich Schiller University Jena, German Center for Mental Health (DZPG) (Author)

Abstract

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.

Details

Original languageEnglish
Article number152532
JournalComprehensive psychiatry
Volume135
Publication statusPublished - Nov 2024
Peer-reviewedYes

External IDs

PubMed 39341174
ORCID /0000-0003-3372-1106/work/175220014

Keywords

Keywords

  • latent change score modelling, longitudinal, personality functioning, psychotherapy, treatment outcome