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Self-Criticism and Personality Functioning Predict Patterns of Symptom Change in Major Depressive Disorder

Aim of the study was to identify patient variables that predict specific patterns of symptom course during and after hospital treatment for major depressive disorder (MDD). In a sample of 518 patients, four pairs of clinically relevant patterns of symptom change were contrasted. The time points of m...

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Autores principales: Zeeck, Almut, von Wietersheim, Jörn, Weiss, Heinz, Hermann, Sabine, Endorf, Katharina, Lau, Inga, Hartmann, Armin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081790/
https://www.ncbi.nlm.nih.gov/pubmed/32226398
http://dx.doi.org/10.3389/fpsyt.2020.00147
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author Zeeck, Almut
von Wietersheim, Jörn
Weiss, Heinz
Hermann, Sabine
Endorf, Katharina
Lau, Inga
Hartmann, Armin
author_facet Zeeck, Almut
von Wietersheim, Jörn
Weiss, Heinz
Hermann, Sabine
Endorf, Katharina
Lau, Inga
Hartmann, Armin
author_sort Zeeck, Almut
collection PubMed
description Aim of the study was to identify patient variables that predict specific patterns of symptom course during and after hospital treatment for major depressive disorder (MDD). In a sample of 518 patients, four pairs of clinically relevant patterns of symptom change were contrasted. The time points of measurement were admission, discharge, 3 and 12 month after discharge. CATREG was used to identify the best sets of predictors from 28 variables. A greater reduction in self-criticism during hospital treatment was the strongest predictor of rapid and sustained improvement. Traumatic childhood experiences and lower abilities for communication with others predicted a transient relapse after discharge, while a co-morbid personality disorder and higher level of anxiety differentiated between those with a persistent relapse and those with only a transient relapse in depressive symptoms following discharge. Overall, patients with less severe depression at admission, better abilities in self-perception, and less self-criticism (baseline and/or greater reduction during treatment) showed a better outcome after 1 year. There is limited generalizability to other countries and treatment settings. Data on personality functioning were not available for all patients and findings are correlational in nature. However, findings are in support of a psychotherapeutic focus on a reduction of self-criticism in MDD. Patient with traumatization, a co-morbid personality disorder and lower abilities to communicate their emotional needs should get specific attention and support after discharge from hospital treatment.
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spelling pubmed-70817902020-03-27 Self-Criticism and Personality Functioning Predict Patterns of Symptom Change in Major Depressive Disorder Zeeck, Almut von Wietersheim, Jörn Weiss, Heinz Hermann, Sabine Endorf, Katharina Lau, Inga Hartmann, Armin Front Psychiatry Psychiatry Aim of the study was to identify patient variables that predict specific patterns of symptom course during and after hospital treatment for major depressive disorder (MDD). In a sample of 518 patients, four pairs of clinically relevant patterns of symptom change were contrasted. The time points of measurement were admission, discharge, 3 and 12 month after discharge. CATREG was used to identify the best sets of predictors from 28 variables. A greater reduction in self-criticism during hospital treatment was the strongest predictor of rapid and sustained improvement. Traumatic childhood experiences and lower abilities for communication with others predicted a transient relapse after discharge, while a co-morbid personality disorder and higher level of anxiety differentiated between those with a persistent relapse and those with only a transient relapse in depressive symptoms following discharge. Overall, patients with less severe depression at admission, better abilities in self-perception, and less self-criticism (baseline and/or greater reduction during treatment) showed a better outcome after 1 year. There is limited generalizability to other countries and treatment settings. Data on personality functioning were not available for all patients and findings are correlational in nature. However, findings are in support of a psychotherapeutic focus on a reduction of self-criticism in MDD. Patient with traumatization, a co-morbid personality disorder and lower abilities to communicate their emotional needs should get specific attention and support after discharge from hospital treatment. Frontiers Media S.A. 2020-03-12 /pmc/articles/PMC7081790/ /pubmed/32226398 http://dx.doi.org/10.3389/fpsyt.2020.00147 Text en Copyright © 2020 Zeeck, von Wietersheim, Weiss, Hermann, Endorf, Lau and Hartmann. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Zeeck, Almut
von Wietersheim, Jörn
Weiss, Heinz
Hermann, Sabine
Endorf, Katharina
Lau, Inga
Hartmann, Armin
Self-Criticism and Personality Functioning Predict Patterns of Symptom Change in Major Depressive Disorder
title Self-Criticism and Personality Functioning Predict Patterns of Symptom Change in Major Depressive Disorder
title_full Self-Criticism and Personality Functioning Predict Patterns of Symptom Change in Major Depressive Disorder
title_fullStr Self-Criticism and Personality Functioning Predict Patterns of Symptom Change in Major Depressive Disorder
title_full_unstemmed Self-Criticism and Personality Functioning Predict Patterns of Symptom Change in Major Depressive Disorder
title_short Self-Criticism and Personality Functioning Predict Patterns of Symptom Change in Major Depressive Disorder
title_sort self-criticism and personality functioning predict patterns of symptom change in major depressive disorder
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081790/
https://www.ncbi.nlm.nih.gov/pubmed/32226398
http://dx.doi.org/10.3389/fpsyt.2020.00147
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