title: Do Patient Characteristics Predict Outcome of Psychodynamic Psychotherapy for Social Anxiety Disorder?
abstract: OBJECTIVE
  Little is known about patient characteristics as predictors for outcome in manualized short term psychodynamic psychotherapy (PDT). No study has addressed which patient variables predict outcome of PDT for social anxiety disorder.
  
  
  METHODS
  In the largest multicenter trial on psychotherapy of social anxiety (SA) to date comparing cognitive therapy, PDT and wait list condition N = 230 patients were assigned to receive PDT, of which N = 166 completed treatment. Treatment outcome was assessed based on diverse parameters such as endstate functioning, remission, response, and drop-out. The relationship between patient characteristics (demographic variables, mental co-morbidity, personality, interpersonal problems) and outcome was analysed using logistic and linear regressions.
  
  
  RESULTS
  Pre-treatment SA predicted up to 39 percent of variance of outcome. Only few additional baseline characteristics predicted better treatment outcome (namely, lower comorbidity and interpersonal problems) with a limited proportion of incremental variance (5.5 to 10 percent), while, e.g., shame, self-esteem or harm avoidance did not.
  
  
  CONCLUSIONS
  We argue that the central importance of pre-treatment symptom severity for predicting outcomes should advocate alternative treatment strategies (e.g. longer treatments, combination of psychotherapy and medication) in those who are most disturbed. Given the relatively small amount of variance explained by the other patient characteristics, process variables and patient-therapist interaction should additionally be taken into account in future research.
  
  
  BACKGROUND
  Controlled-trials.com/ISRCTN53517394.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltink
authors.affiliation: Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hoyer
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Manfred E
authors.initials: ME
authors.lastname: Beutel
authors.affiliation: Interdisciplinary Centre for Clinical Trials (IZKS), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Ruckes
authors.affiliation: Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Herpertz
authors.affiliation: Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Joraschky
authors.affiliation: Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Jena, Germany.
authors.forename: Susan
authors.initials: S
authors.lastname: Koranyi
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Michal
authors.affiliation: Clinic of Psychosomatics and Psychotherapeutic Medicine, Esslingen, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Nolting
authors.affiliation: Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Pöhlmann
authors.affiliation: Clinic of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Salzer
authors.affiliation: Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Jena, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Strauss
authors.affiliation: Clinic of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany.
authors.forename: Eric
authors.initials: E
authors.lastname: Leibing
authors.affiliation: Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Leichsenring
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D064889:Psychotherapy, Psychodynamic; D012920:Social Behavior Disorders / Q000523:psychology / Q000628:therapy*; D055815:Young Adult