Effects of client-centered psychotherapy for personality disorders alone and in combination with psychopharmacological treatment. An empirical follow-up study.
BACKGROUND
: There is an increasing interest concerning the treatment of patients with personality disorders (PD) in data on the efficacy of psychotherapeutic strategies especially when combined with medication.


METHODS
The efficacy of an inpatient client-centered treatment program (CCT) was studied prospectively in 142 patients with PD and additional depressive, anxiety or eating disorders (ICD-10).


RESULTS
Significant improvements in depression, self-esteem and social adjustment were achieved up to discharge, which remained stable at the 1-year follow-up. The efficacy with regard to individual variables or the total result could not be further enhanced by a combination with psychopharmacological treatment (CCT + MED), consisting mainly of antidepressants. Within the subgroups of patients with socially deviant (F60.0-2), emotionally unstable/borderline (F60.3) and histrionic/narcissistic PD (F60.4, F60.8), CCT was significantly superior to CCT + MED in the reduction of depression (Bech-Rafaelsen Melancholia Scale ratings), whereas the response was enhanced by medication in the subgroup of patients with socially dependent 'cluster C' PD (F60.5-7).


CONCLUSIONS
The results are discussed with regard to client-centered therapeutic concepts and to the further development of differential combination strategies.
Teusch
L
L
Department of Psychiatry and Psychotherapy, Evangelisches Krankenhaus Castrop-Rauxel, Germany.
Böhme
H
H
Finke
J
J
Gastpar
M
M
D000328:Adult; D000704:Analysis of Variance; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents