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Symptom- and personality disorder changes in intensive short-term dynamic residential treatment for treatment-resistant anxiety and depressive disorders

Published online by Cambridge University Press:  26 February 2016

Ole André Solbakken  and
Allan Abbass
Ole André Solbakken*
Affiliation:
The Department of Psychology, University of Oslo, Oslo, Norway Drammen District Psychiatric Centre, Division for Mental Health and Addiction, Vestre Viken Health Trust, Drammen, Norway
Allan Abbass
Affiliation:
The Centre for Emotions and Health, Dalhousie University, Halifax, NS, Canada
*
Ole André Solbakken, The Department of Psychology, University of Oslo, Postboks 1094 Blindern, 0317 Oslo, Norway. Tel: +47 22 84 51 80; Fax: +47 22 84 50 01; E-mail: o.a.solbakken@psykologi.uio.no
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Abstract

Objective

The study investigated the effectiveness of an 8-week intensive residential treatment programme based on principles from intensive short-term dynamic psychotherapy for patients with known treatment-resistant anxiety- and/or depressive disorders (mainly with comorbid personality disorders).

Methods

Patients (N=95) with prior repeated treatment failure were included. Changes in self-reported target complaints, symptom severity, and overall interpersonal problems have been presented for these patients in two previous articles. We now expand upon the existing knowledge by presenting novel data from a number of important observer-based and self-reported outcome domains (diagnostic changes on Axis I and II, changes in overall personality dysfunction, disorder complexity, medication use, health care utilisation, and occupational activity).

Results

There were pervasive and significant improvements on all measures during treatment, which were maintained or further improved during follow-up. Fourteen months after the end of treatment, 46.26% of patients had recovered in terms of Axis I pathology, 63.79% had recovered in terms of Axis II pathology, 71.18% had returned to work, and there was a 28.62% reduction in regular use of psychotropic medications. Health care utilisation was reduced by 65.55%, and there were large improvements in disorder complexity and levels of personality dysfunction.

Conclusion

The treatment programme was highly effective for patients with common and complex treatment-resistant mental disorders. Results are encouraging for the relatively large number of patients who tend not to benefit from standard formats of treatment for debilitating psychological problems.

Keywords

anxietydepressionpersonality disorderpsychodynamic psychotherapytreatment resistance
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 28 , Issue 5 , October 2016 , pp. 257 - 271
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Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

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