[Operationalized psychodynamic diagnostics (OPD) in patients in a prodromal state of schizophrenia--an explorative study].
OBJECTIVE
To obtain data and hypotheses regarding the amelioration of risk estimation and preventive psychotherapy in patients in a prodromal state of schizophrenia by using OPD.


METHODS
20 participants with a prodromal condition--6 subjects far from psychosis and 14 close to psychosis--along with 10 patients with paranoid schizophrenia as reference group were examined using the first four OPD axes.


RESULTS
Both groups differed considerably in all four axes. Compared to the schizophrenic participants, prodromal probands appear to have more favourable preconditions for therapy. Moreover, they experienced the interaction partners, including the investigator, as less aversive and induced less distanced behaviour in the investigator. Conflicts of self-esteem were prominent in both prodromal subgroups. However, patients farther from psychosis showed less conflicts of autonomy versus dependence and displayed a higher integration in structures such as "defence" and "attachment" when compared to participants closer to psychosis.


CONCLUSIONS
Particularly the differences between the prodromal subgroups suggest that application of the OPD may positively complement previous approaches of early detection, prevention,and psychotherapy for prodromal conditions. The hypotheses obtained should be tested in longitudinal studies with larger sample sizes.
Uzdawinis
Dorota
D
Frütherkennungs- und Therapiezentrum for beginnende Psychosen Berlin-Brandenburg, Klinik for Psychiatrie und Psychotherapie der Charité, Berlin.
Edel
Marc-Andreas
MA
Ozgürdal
Seza
S
von Haebler
Dorothea
D
Hauser
Marta
M
Witthaus
Henning
H
Gudlowski
Yehonala
Y
Heinz
Andreas
A
Juckel
Georg
G
D000328:Adult; D003220:Conflict, Psychological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011575:Psychoanalytic Therapy; D011594:Psychometrics; D018570:Risk Assessment; D012563:Schizophrenia, Paranoid / Q000145:classification / Q000175:diagnosis* / Q000517:prevention & control; D012569:Schizotypal Personality Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology