Long-term effects of transference interpretation in dynamic psychotherapy of personality disorders.
BACKGROUND
Only a few treatment studies of personality disorders (PD) patients are on longer-term psychotherapy, general outcome measures are used, and follow-up periods are usually short. More studies of long-term therapies, using outcome measures of core psychopathology, are needed.


METHODS
This study is a dismantling randomized controlled clinical trial, specifically designed to study long-term effects of transference interpretation. Forty-six patients with mainly cluster C personality disorders were randomly assigned to 1 year of dynamic psychotherapy with or without transference interpretations. The outcome measures were remission from PD, improvement in interpersonal functioning, and use of mental health resources in the 3-year period after treatment termination.


RESULTS
After therapy with transference interpretation PD-patients improved significantly more in core psychopathology and interpersonal functioning, the drop-out rate was reduced to zero, and use of health services was reduced to 50%, compared to therapy without this ingredient. Three years after treatment termination, 73% no longer met diagnostic criteria for any PD in the transference group, compared to 44% in the comparison group.


CONCLUSIONS
PD-patients with co-morbid disorders improved in both treatment arms in this study. However, transference interpretation improved outcome substantially more. Long-term psychotherapy that includes transference interpretation is an effective treatment for cluster C personality disorders and milder cluster B personality disorders.
Høglend
P
P
Department of psychiatry, University of Oslo, P.O. Box 85, Vinderen, 0319 Oslo, Norway. p.a.hoglend@medisin.uio.no
Dahl
H-S
HS
Hersoug
A G
AG
Lorentzen
S
S
Perry
J C
JC
D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D017063:Outcome Assessment, Health Care / Q000379:methods; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D010552:Personality Assessment; D010554:Personality Disorders / Q000175:diagnosis / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011580:Psychological Techniques; D011613:Psychotherapy / Q000379:methods*; D012074:Remission Induction; D013995:Time; D014167:Transference, Psychology