Operationalized psychodynamic diagnosis system and outcome of psychodynamic inpatient psychotherapy in male and female patients

Abstract

Objective: To compare male and female patients with regard to the Operationalized Psychodynamic Diagnosis (OPD-2) system, treatment variables, and outcome after multimodal psychodynamic inpatient psychotherapy. Methods: At the beginning and at the end of inpatient treatment in a multimodal psychodynamic setting, patients were examined with the OPD-2 system as well as with three self-assessment questionnaires addressing interpersonal problems (Inventory of Interpersonal Problems, IIP), and psychopathology: Brief Symptom Inventory (BSI) and the Hospital Anxiety and Depression Scale (HADS). Results: Data of 850 patients (238 males, 28%), 612 females, 72%) were available for analysis. There were differences between men and women in the main diagnoses, with a higher proportion of eating disorders and a longer treatment duration among the women. Therapy discontinuation rates were low and did not differ between the sexes. Women scored higher on psychopathology at admission on the BSI Global Score, IIP and anxiety; the pattern of reported interpersonal problems was consistent with sex roles. While the level of structural integration was similar in both sexes, the distribution of the two main conflicts and the level of improvement of awareness and dealing with the psychodynamic foci showed significant differences. Overall, at the end of inpatient psychotherapy, there was a mean improvement in both men and women, with no significant differences between them. Because of higher scores at the start of psychotherapy, the effect sizes for improvement were higher for women. Conclusions: On the whole, both sexes seem to benefit equally from psychodynamic inpatient psychotherapy in terms of symptom improvement.