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Susanne S. Pedersen - One of the best experts on this subject based on the ideXlab platform.

  • one year results of the randomized controlled Short Term Psychotherapy in acute myocardial infarction step in ami trial
    International Journal of Cardiology, 2013
    Co-Authors: Adriana Roncella, Cinzia Cianfrocca, Vincenzo Pasceri, Francesco Pelliccia, Johan Denollet, Susanne S. Pedersen, Christian Pristipino, Silvia Scorza
    Abstract:

    Abstract Background Previous studies on cognitive and interpersonal interventions have yielded inconsistent results in ischemic heart disease patients. Methods 101 patients aged ≤70years, and enrolled one week after complete revascularization with urgent/emergent angioplasty for an AMI, were randomized to standard cardiological therapy plus Short-Term humanistic–existential Psychotherapy (STP) versus standard cardiological therapy only. Primary composite end point was: one-year incidence of new cardiological events (re-infarction, death, stroke, revascularization, life-threatening ventricular arrhythmias, and the recurrence of typical and clinically significant angina) and of clinically significant new comorbidities. Secondary end points were: rates for individual components of the primary outcome, incidence of re-hospitalizations for cardiological problems, New York Heart Association class, and psychometric test scores at follow-up. Results 94 patients were analyzed at one year. The two treatment groups were similar across all baseline characteristics. At follow-up, STP patients had had a lower incidence of the primary endpoint, relative to controls (21/49 vs. 35/45 patients; p=0.0006, respectively; NNT=3); this benefit was attributable to the lower incidence of recurrent angina and of new comorbidities in the STP group (14/49 vs. 22/45 patients, p=0.04, NNT=5; and 5/49 vs. 25/45, p Conclusion Adding STP to cardiological therapy improves cardiological symptoms, quality of life, and psychological and medical outcomes one year post AMI, while reducing the need for re-hospitalizations. Larger studies remain necessary to confirm the generalizability of these results. Clinical trial registration ClinicalTrial.gov: NCT00769366

  • Rationale and trial design of a randomized, controlled study on Short-Term Psychotherapy after acute myocardial infarction: the STEP-IN-AMI trial (Short Term Psychotherapy in Acute Myocardial Infarction).
    Journal of Cardiovascular Medicine, 2009
    Co-Authors: Adriana Roncella, Antonella Giornetti, Cinzia Cianfrocca, Vincenzo Pasceri, Francesco Pelliccia, Johan Denollet, Susanne S. Pedersen, Giulio Speciale, Giuseppe Richichi, Christian Pristipino
    Abstract:

    OBJECTIVE A number of previous studies addressed the effect of psychological interventions in patients after acute myocardial infarction (AMI), but it is not known whether Psychotherapy might be beneficial after medical and interventional therapy of AMI. We designed a randomized, controlled study to assess the effects of a Short-Term Psychotherapy (STP) on the clinical outcomes of patients who underwent an emergency percutaneous coronary intervention after AMI. METHODS One hundred consecutive patients undergoing an emergency percutaneous coronary intervention will be randomized 1 week after AMI to medical therapy (control group, C group) or to medical therapy and STP (STP group). Clinical follow-up visits are scheduled at 6 months, 1 and 5 years, whereas psychometric tests (Self-Evaluation test, Modified Maastricht Questionnaire, Social Support Questionnaire, Recent Life Change Questionnaire, Beck Depression Inventory, the MacNew Heart Disease Health-Related Quality of Life Questionnaire, Type D Personality test) are scheduled 1 week after AMI and at 1 year. The primary outcome measures of the study are the cumulative incidence of new cardiological events (myocardial reinfarction, death, stroke, life-threatening ventricular arrhythmias, and recurrence of angina) and the occurrence of new medical disorders. Secondary outcome measures are the incidence of rehospitalizations due to cardiological problems, the prevalence of patients with New York Heart Association class > or = II, left ventricular function, as assessed by echocardiography, and mean score of psychometric tests in the two groups at follow-up. CONCLUSION Our study has been planned to obtain an insight into how a STP influences clinical outcomes after interventional and medical treatment of AMI.

Anthony S Joyce - One of the best experts on this subject based on the ideXlab platform.

  • Residual symptoms in depressed patients who successfully respond to Short-Term Psychotherapy.
    Journal of Affective Disorders, 2004
    Co-Authors: John S Ogrodniczuk, William E Piper, Anthony S Joyce
    Abstract:

    Background: Most investigations of residual symptoms have focused on partial responders to antidepressant medications. Comparatively few have examined residual symptoms among patients who achieved a more successful response to treatment. In addition, few studies have assessed residual symptoms among patients treated with Psychotherapy. The purpose of the present study was to assess residual symptoms of depression among psychiatric outpatients who successfully responded to Psychotherapy and deTermine their association with other important clinical outcomes. Methods: Sixty patients with major depression who participated in a randomized controlled trial of two forms of Short-Term, individual Psychotherapy were studied. We examined the prevalence of residual symptoms among successful responders, as well as the relationships between residual symptoms, pre-therapy patient characteristics, relapse, and other outcomes. Results: Thirty-three (55%) of the 60 patients responded successfully to Psychotherapy. Of those, 82% had residual symptoms. Residual symptoms predicted relapse at 6-month follow-up, and were associated with less favorable psychosocial functioning at post-therapy and at 6-month follow-up. Limitations: The study consisted of post-hoc analyses of existing data, the number of asymptomatic patients was small, and a proxy measure of relapse was used. Conclusions: Residual symptoms are prevalent among depressed patients who successfully respond to Psychotherapy. Greater residual symptoms appear to increase the risk for relapse and are associated with poorer psychosocial functioning.

  • Alexithymia as a predictor of residual symptoms in depressed patients who respond to Short-Term Psychotherapy.
    American Journal of Psychotherapy, 2004
    Co-Authors: John S Ogrodniczuk, William E Piper, Anthony S Joyce
    Abstract:

    Residual symptoms are increasingly becoming recognized as an important problem in the treatment of major depression. It is unclear which individuals are more likely to suffer from residual symptoms...

  • relationships among psychological mindedness alexithymia and outcome in four forms of Short Term Psychotherapy
    Psychology and Psychotherapy-theory Research and Practice, 2003
    Co-Authors: Mary Mccallum, John S Ogrodniczuk, William E Piper, Anthony S Joyce
    Abstract:

    This study explored the relative strength of two patient characteristics, psychological mindedness (PM) and alexithymia, as predictors of Psychotherapy outcome. Data were provided by two comparative trials of interpretive versus supportive therapy. One involved Short-Term group therapy for 107 outpatients with complicated grief. The other involved Short-Term individual therapy for 144 outpatients of mixed diagnoses. Prior to beginning therapy, patients were assessed for PM using the Psychological Mindedness Assessment Procedure and for alexithymia using the 20-item Toronto Alexithymia Scale. For both trials, the association between PM and alexithymia was small and non-significant. The therapy approach (interpretive vs. supportive) did not differentially affect the relationship between either predictor variable and outcome. There were significant direct relationships between PM and favourable outcome, and between alexithymia and favourable outcome in both trials. There was an additive relationship between PM and alexithymia in predicting outcome. Implications of these results are discussed.

  • Concentration and Correspondence of Transference Interpretations in Short-Term Psychotherapy
    Journal of Consulting and Clinical Psychology, 1993
    Co-Authors: William E Piper, Anthony S Joyce, Mary Mccallum, Hassan F. A. Azim
    Abstract:

    This article provides a review of research on the relationship between aspects of transference interpretation and outcome in dynamic Psychotherapy. It also presents the results of a recently completed study that focused on 2 aspects of transference interpretations, concentration and correspondence. Significant relationships between each of these 2 aspects and both therapeutic alliance and outcome were found, as well as an interaction effect for outcome. The relationships differed as a function of the patient personality characteristic known as quality of object relations. The results concerning correspondence were consistent with those of previous studies that investigated the correctness of interpretatio ns. The overall findings suggest that (a) variation in technique may make a difference in brief dynamic therapy and (b) variation and impact of technique may have been masked in some previous studies and reviews. One of the central and distinguishing technical features of psychoanalytical ly oriented Psychotherapy (subsequently referred to as dynamic therapy) is the interpretation of transference. By interpretation, we refer to the actual statements made by the therapist to the patient in an attempt to enhance the patient's understanding of his or her experiences. This is related to, but distinct from, the therapist's internal process of understanding the patient. In general, the intent of interpretation is to produce an alteration in the patient's intrapsychic conflicts to permit improved functioning (Brenner, 1976). Transference interpretations focus on the patient's reactions to the therapist. They may be, but are not necessarily, linked to the patient's reactions to other important people. This article provides a review of research that has examined the relationship between aspects of transference interpretation and outcome in dynamic therapy. In addition, the results of a study of time-limited therapy that was recently completed in our center is presented. The investigation of the impact of transference interpretation is an important area in the field of Psychotherapy process research. A general problem in this field, which was highlighted by Garfield (1990), is a deficiency of replication and cross-validation of findings; this involves both ascarcity of replication attempts and inconsistent results when replications have been attempted. In recent years, however, some lines of convergence regarding the impact of interpretation have emerged in

Manfred E. Beutel - One of the best experts on this subject based on the ideXlab platform.

  • does psychodynamic Short Term Psychotherapy for depressed breast cancer patients also improve fatigue results from a randomized controlled trial
    Breast Cancer Research and Treatment, 2015
    Co-Authors: Gregor Weisflog, Elmar Brahler, Katja Leuteritz, Yvette Barthel, Susanne Kuhnt, Jorg Wiltink, Rudiger Zwerenz, Manfred E. Beutel
    Abstract:

    The purpose of this study was to deTermine (a) the course of fatigue in depressed breast cancer patients, (b) the effect of a depression-focused individual psychodynamic Psychotherapy on fatigue, and (c) the associations of fatigue with depression, quality of life and treatment-related variables. In a German multicentre randomized controlled trial in Leipzig and Mainz, depressed early breast cancer patients (UICC stage 0–III, age 18–70 years) were randomly assigned to a Short-Term psychodynamic Psychotherapy (STPP, an adaptation of the Supportive-Expressive Psychotherapy by Luborsky for cancer patients) or treatment as usual (TAU) and completed data assessment pre- and post-treatment. Fatigue was assessed with the Multidimensional Fatigue Inventory (MFI-20). All analyses were conducted as complete case analyses including 52 STPP and 54 TAU completers (n = 106). The trial is registered at http://www.controlled-trials.com, number ISRCTN96793588. Fatigue declined significantly from a high level pre-treatment to post-treatment, but remained significantly higher than among population-based controls and a mixed sample of cancer patients. Significant time by group interactions favoured STPP for the subscales reduced activity and physical fatigue and the total scale. The strength of the associations between total fatigue and depression increased from 0.49 pre-treatment to 0.63 (Quality of life −0.52 to −0.63) at follow-up. STPP is beneficial for reducing dimensions of fatigue (particularly reduced activity and physical fatigue) in depressed breast cancer patients. Chronic fatigue needs more clinical attention in this vulnerable group.

  • Who benefits from inpatient Short-Term Psychotherapy in the long run? Patients' evaluations, outpatient after-care and deTerminants of outcome.
    Psychology and Psychotherapy-theory Research and Practice, 2005
    Co-Authors: Manfred E. Beutel, A. Höflich, R. A. Kurth, Ch. Reimer
    Abstract:

    Background. Little work has been published on Short-Term inpatient treatments combining the virtues of inpatient treatments and Short-Term Psychotherapy. The purposes of this study are to (a) deTermine the outcomes of Short-Term psychodynamic inpatient Psychotherapy from patients' and therapists' perspectives, (b) assess the stability of changes, and (c) identify predictors of long-Term outcome. Methods. 83 consecutive inpatients (76% of those eligible) were assessed at intake, discharge, and 1 year follow-up by standardized questionnaires regarding symptoms (SCL-90R), interpersonal problems (IIP), object relationships (IPO), and the therapeutic relationship (HAQ). Diagnoses and functioning (GAF) were assessed by the therapists. Results. Psychological distress (effect size S=1.14) and physical complaints (ES=1.03) decreased strongly from intake to discharge, the majority of patients moving from the pathological to the normal range of the global severity index GSI (SCL-90R). At follow-up, average distress remained at a low level, and the majority of patients, and their therapists and physicians, regarded their well-being as improved. In a multivariate approach, a substantial proportion of variance of the distress at follow-up (42%) was explained by an infantile object relationship pattern (IPO), social avoidance (IIP), negative vocational changes, and a lack of a confidant at follow-up. A delayed start of subsequent ambulatory Psychotherapy was another negative outcome predictor. Conclusions. Attention should be given to maladaptive interpersonal relationship patterns, to vocational reintegration, and a confiding relationship as potential predictors of long-Term outcome. Also, patterns of ambulatory after-care following inpatient treatment need further scrutiny.

  • Who benefits from inpatient Short-Term Psychotherapy in the long run? Patients' evaluations, outpatient after-care and deTerminants of outcome.
    Psychology and psychotherapy, 2005
    Co-Authors: Manfred E. Beutel, A. Höflich, R. A. Kurth, Ch. Reimer
    Abstract:

    Little work has been published on Short-Term inpatient treatments combining the virtues of inpatient treatments and Short-Term Psychotherapy. The purposes of this study are to (a) deTermine the outcomes of Short-Term psychodynamic inpatient Psychotherapy from patients' and therapists' perspectives, (b) assess the stability of changes, and (c) identify predictors of long-Term outcome. 83 consecutive inpatients (76% of those eligible) were assessed at intake, discharge, and 1 year follow-up by standardized questionnaires regarding symptoms (SCL-90R), interpersonal problems (IIP), object relationships (IPO), and the therapeutic relationship (HAQ). Diagnoses and functioning (GAF) were assessed by the therapists. Psychological distress (effect size S = 1.14) and physical complaints (ES = 1.03) decreased strongly from intake to discharge, the majority of patients moving from the pathological to the normal range of the global severity index GSI (SCL-90R). At follow-up, average distress remained at a low level, and the majority of patients, and their therapists and physicians, regarded their well-being as improved. In a multivariate approach, a substantial proportion of variance of the distress at follow-up (42%) was explained by an infantile object relationship pattern (IPO), social avoidance (IIP), negative vocational changes, and a lack of a confidant at follow-up. A delayed start of subsequent ambulatory Psychotherapy was another negative outcome predictor. Attention should be given to maladaptive interpersonal relationship patterns, to vocational reintegration, and a confiding relationship as potential predictors of long-Term outcome. Also, patterns of ambulatory after-care following inpatient treatment need further scrutiny.

Elmar Brahler - One of the best experts on this subject based on the ideXlab platform.

  • does psychodynamic Short Term Psychotherapy for depressed breast cancer patients also improve fatigue results from a randomized controlled trial
    Breast Cancer Research and Treatment, 2015
    Co-Authors: Gregor Weisflog, Elmar Brahler, Katja Leuteritz, Yvette Barthel, Susanne Kuhnt, Jorg Wiltink, Rudiger Zwerenz, Manfred E. Beutel
    Abstract:

    The purpose of this study was to deTermine (a) the course of fatigue in depressed breast cancer patients, (b) the effect of a depression-focused individual psychodynamic Psychotherapy on fatigue, and (c) the associations of fatigue with depression, quality of life and treatment-related variables. In a German multicentre randomized controlled trial in Leipzig and Mainz, depressed early breast cancer patients (UICC stage 0–III, age 18–70 years) were randomly assigned to a Short-Term psychodynamic Psychotherapy (STPP, an adaptation of the Supportive-Expressive Psychotherapy by Luborsky for cancer patients) or treatment as usual (TAU) and completed data assessment pre- and post-treatment. Fatigue was assessed with the Multidimensional Fatigue Inventory (MFI-20). All analyses were conducted as complete case analyses including 52 STPP and 54 TAU completers (n = 106). The trial is registered at http://www.controlled-trials.com, number ISRCTN96793588. Fatigue declined significantly from a high level pre-treatment to post-treatment, but remained significantly higher than among population-based controls and a mixed sample of cancer patients. Significant time by group interactions favoured STPP for the subscales reduced activity and physical fatigue and the total scale. The strength of the associations between total fatigue and depression increased from 0.49 pre-treatment to 0.63 (Quality of life −0.52 to −0.63) at follow-up. STPP is beneficial for reducing dimensions of fatigue (particularly reduced activity and physical fatigue) in depressed breast cancer patients. Chronic fatigue needs more clinical attention in this vulnerable group.

William E Piper - One of the best experts on this subject based on the ideXlab platform.

  • Residual symptoms in depressed patients who successfully respond to Short-Term Psychotherapy.
    Journal of Affective Disorders, 2004
    Co-Authors: John S Ogrodniczuk, William E Piper, Anthony S Joyce
    Abstract:

    Background: Most investigations of residual symptoms have focused on partial responders to antidepressant medications. Comparatively few have examined residual symptoms among patients who achieved a more successful response to treatment. In addition, few studies have assessed residual symptoms among patients treated with Psychotherapy. The purpose of the present study was to assess residual symptoms of depression among psychiatric outpatients who successfully responded to Psychotherapy and deTermine their association with other important clinical outcomes. Methods: Sixty patients with major depression who participated in a randomized controlled trial of two forms of Short-Term, individual Psychotherapy were studied. We examined the prevalence of residual symptoms among successful responders, as well as the relationships between residual symptoms, pre-therapy patient characteristics, relapse, and other outcomes. Results: Thirty-three (55%) of the 60 patients responded successfully to Psychotherapy. Of those, 82% had residual symptoms. Residual symptoms predicted relapse at 6-month follow-up, and were associated with less favorable psychosocial functioning at post-therapy and at 6-month follow-up. Limitations: The study consisted of post-hoc analyses of existing data, the number of asymptomatic patients was small, and a proxy measure of relapse was used. Conclusions: Residual symptoms are prevalent among depressed patients who successfully respond to Psychotherapy. Greater residual symptoms appear to increase the risk for relapse and are associated with poorer psychosocial functioning.

  • Alexithymia as a predictor of residual symptoms in depressed patients who respond to Short-Term Psychotherapy.
    American Journal of Psychotherapy, 2004
    Co-Authors: John S Ogrodniczuk, William E Piper, Anthony S Joyce
    Abstract:

    Residual symptoms are increasingly becoming recognized as an important problem in the treatment of major depression. It is unclear which individuals are more likely to suffer from residual symptoms...

  • relationships among psychological mindedness alexithymia and outcome in four forms of Short Term Psychotherapy
    Psychology and Psychotherapy-theory Research and Practice, 2003
    Co-Authors: Mary Mccallum, John S Ogrodniczuk, William E Piper, Anthony S Joyce
    Abstract:

    This study explored the relative strength of two patient characteristics, psychological mindedness (PM) and alexithymia, as predictors of Psychotherapy outcome. Data were provided by two comparative trials of interpretive versus supportive therapy. One involved Short-Term group therapy for 107 outpatients with complicated grief. The other involved Short-Term individual therapy for 144 outpatients of mixed diagnoses. Prior to beginning therapy, patients were assessed for PM using the Psychological Mindedness Assessment Procedure and for alexithymia using the 20-item Toronto Alexithymia Scale. For both trials, the association between PM and alexithymia was small and non-significant. The therapy approach (interpretive vs. supportive) did not differentially affect the relationship between either predictor variable and outcome. There were significant direct relationships between PM and favourable outcome, and between alexithymia and favourable outcome in both trials. There was an additive relationship between PM and alexithymia in predicting outcome. Implications of these results are discussed.

  • Concentration and Correspondence of Transference Interpretations in Short-Term Psychotherapy
    Journal of Consulting and Clinical Psychology, 1993
    Co-Authors: William E Piper, Anthony S Joyce, Mary Mccallum, Hassan F. A. Azim
    Abstract:

    This article provides a review of research on the relationship between aspects of transference interpretation and outcome in dynamic Psychotherapy. It also presents the results of a recently completed study that focused on 2 aspects of transference interpretations, concentration and correspondence. Significant relationships between each of these 2 aspects and both therapeutic alliance and outcome were found, as well as an interaction effect for outcome. The relationships differed as a function of the patient personality characteristic known as quality of object relations. The results concerning correspondence were consistent with those of previous studies that investigated the correctness of interpretatio ns. The overall findings suggest that (a) variation in technique may make a difference in brief dynamic therapy and (b) variation and impact of technique may have been masked in some previous studies and reviews. One of the central and distinguishing technical features of psychoanalytical ly oriented Psychotherapy (subsequently referred to as dynamic therapy) is the interpretation of transference. By interpretation, we refer to the actual statements made by the therapist to the patient in an attempt to enhance the patient's understanding of his or her experiences. This is related to, but distinct from, the therapist's internal process of understanding the patient. In general, the intent of interpretation is to produce an alteration in the patient's intrapsychic conflicts to permit improved functioning (Brenner, 1976). Transference interpretations focus on the patient's reactions to the therapist. They may be, but are not necessarily, linked to the patient's reactions to other important people. This article provides a review of research that has examined the relationship between aspects of transference interpretation and outcome in dynamic therapy. In addition, the results of a study of time-limited therapy that was recently completed in our center is presented. The investigation of the impact of transference interpretation is an important area in the field of Psychotherapy process research. A general problem in this field, which was highlighted by Garfield (1990), is a deficiency of replication and cross-validation of findings; this involves both ascarcity of replication attempts and inconsistent results when replications have been attempted. In recent years, however, some lines of convergence regarding the impact of interpretation have emerged in