Stress, depression, and the therapeutic alliance as mediators on the outcome of brief psychodynamic-interpersonal psychotherapy for multisomatoform disorder. 2021

Elke Humer, and Heribert Sattel, and Harald Gündel, and Peter Henningsen, and Johannes Kruse, and Gudrun Schneider, and Claas Lahmann, and Christoph Pieh, and Thomas Probst
Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria.

The aim of this study was to identify and explore mediators of psychodynamic-interpersonal psychotherapy (PIT) on treatment outcome in multisomatoform disorders (MSD). Data from 164 patients with MSD who took part in a randomized control trial of PIT (n = 88) vs. enhanced medical care (EMC; n = 76) were re-analyzed. A parallel mediation analysis was performed to investigate whether the beneficial effect of PIT vs. EMC on physical quality of life (physical component summary (PCS) of the SF-36 Health Survey) nine months post-treatment is mediated by post-treatment scores of stress, depression, and therapeutic alliance. The potential mediators were operationalized with the Helping Alliance Questionnaire (HAQ; therapeutic alliance), the Patient Health Questionnaire (PHQ)-stress module (perceived stress) and the PHQ-depression module (PHQ-9; depression). Stress partially mediated the effect of PIT vs. EMC on the follow-up outcome. PIT (as compared to EMC) led to lower post-treatment stress-levels, which in turn led to higher physical quality of life at follow-up. Neither depression nor the alliance had a mediating effect. Stress mediated the outcome of PIT for MSD. Future studies are needed to extend the scope of research regarding which specific psychotherapeutic mechanisms of change are beneficial in PIT treatment of MSD patients.

UI MeSH Term Description Entries
D011613 Psychotherapy A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. Psychotherapies
D011614 Psychotherapy, Brief Any form of psychotherapy designed to produce therapeutic change within a minimal amount of time, generally not more than 20 sessions. Short-Term Psychotherapy,Brief Psychotherapy,Psychotherapy, Short-Term,Solution-Focused Brief Therapy,Brief Psychotherapies,Brief Therapies, Solution-Focused,Brief Therapy, Solution-Focused,Psychotherapies, Brief,Psychotherapies, Short-Term,Psychotherapy, Short Term,Short Term Psychotherapy,Short-Term Psychotherapies,Solution Focused Brief Therapy,Solution-Focused Brief Therapies,Therapies, Solution-Focused Brief,Therapy, Solution-Focused Brief
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D003863 Depression Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders. Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000078462 Therapeutic Alliance A relational factor in counseling that includes three dimensions: goal consensus between counselor and client, collaboration on counseling-related tasks, and emotional bonding. It is referred to as the working alliance between a therapist and a client in psychotherapy and closely correlated with positive client outcomes. Alliance, Therapeutic,Alliances, Therapeutic,Therapeutic Alliances
D000079062 Interpersonal Psychotherapy Interpersonal modification of psychodynamic psychotherapy. Therapy is present-focused and seeks to resolve problems in interpersonal relations. Aspects of attachment theory are used to analyze how past relationships affect current relationships. Psychotherapy, Interpersonal
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D064889 Psychotherapy, Psychodynamic Forms of PSYCHOTHERAPY falling within or deriving from the psychoanalytic tradition, that view individuals as reacting to unconscious forces (e.g., motivation, drive), that focus on processes of change and development, and that place a premium on self understanding and making meaning of what is unconscious. Psychodynamic Psychotherapies,Psychodynamic Psychotherapy,Psychotherapies, Psychodynamic

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