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PLoS One. 2016 Jan 19;11(1):e0147165. doi: 10.1371/journal.pone.0147165. eCollection 2016.

Do Patient Characteristics Predict Outcome of Psychodynamic Psychotherapy for Social Anxiety Disorder?

Author information

1
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
2
Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
3
Interdisciplinary Centre for Clinical Trials (IZKS), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
4
Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Ruhr-University Bochum, Bochum, Germany.
5
Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany.
6
Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Jena, Germany.
7
Clinic of Psychosomatics and Psychotherapeutic Medicine, Esslingen, Germany.
8
Clinic of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany.
9
Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany.

Abstract

OBJECTIVES:

Little is known about patient characteristics as predictors for outcome in manualized short term psychodynamic psychotherapy (PDT). No study has addressed which patient variables predict outcome of PDT for social anxiety disorder.

RESEARCH DESIGN AND METHODS:

In the largest multicenter trial on psychotherapy of social anxiety (SA) to date comparing cognitive therapy, PDT and wait list condition N = 230 patients were assigned to receive PDT, of which N = 166 completed treatment. Treatment outcome was assessed based on diverse parameters such as endstate functioning, remission, response, and drop-out. The relationship between patient characteristics (demographic variables, mental co-morbidity, personality, interpersonal problems) and outcome was analysed using logistic and linear regressions.

RESULTS:

Pre-treatment SA predicted up to 39 percent of variance of outcome. Only few additional baseline characteristics predicted better treatment outcome (namely, lower comorbidity and interpersonal problems) with a limited proportion of incremental variance (5.5 to 10 percent), while, e.g., shame, self-esteem or harm avoidance did not.

CONCLUSIONS:

We argue that the central importance of pre-treatment symptom severity for predicting outcomes should advocate alternative treatment strategies (e.g. longer treatments, combination of psychotherapy and medication) in those who are most disturbed. Given the relatively small amount of variance explained by the other patient characteristics, process variables and patient-therapist interaction should additionally be taken into account in future research.

TRIAL REGISTRATION:

Controlled-trials.com/ISRCTN53517394.

PMID:
26785255
PMCID:
PMC4718454
DOI:
10.1371/journal.pone.0147165
[Indexed for MEDLINE]
Free PMC Article

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