Personality Disorders as a Possible Moderator of the Effects of Relational Interventions in Short-Term Psychoanalytic Psychotherapy with Depressed Adolescents

Hans Ole Korsgaard; Randi Ulberg; Benjamin Hummelen; Nick Midgley; Agneta Thorén; Hanne-Sofie Johnsen Dahl

doi:10.3390/ijerph191710952

Personality Disorders as a Possible Moderator of the Effects of Relational Interventions in Short-Term Psychoanalytic Psychotherapy with Depressed Adolescents

Int J Environ Res Public Health. 2022 Sep 2;19(17):10952. doi: 10.3390/ijerph191710952.

Authors

Hans Ole Korsgaard¹, Randi Ulberg^{2

3

4}, Benjamin Hummelen⁵, Nick Midgley^{6

7}, Agneta Thorén⁸, Hanne-Sofie Johnsen Dahl^{4

9}

Affiliations

¹ The Nic Waal Institute, Lovisenberg Hospital, 0440 Oslo, Norway.
² Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway.
³ Department of Psychiatry, Diakonhjemmet Hospital, 0370 Oslo, Norway.
⁴ Research Unit, Division of Mental Health, Vestfold Hospital Trust, 3116 Tønsberg, Norway.
⁵ Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
⁶ Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London WC1E 6BT, UK.
⁷ Anna Freud National Centre for Children and Families, London N1 9JH, UK.
⁸ The Erica Foundation, 114 24 Stockholm, Sweden.
⁹ Department of Psychology, University of Oslo, 0316 Oslo, Norway.

Abstract

A significant proportion of adolescents suffering from major depressive disorder (MDD) are likely to have a co-morbid personality disorder (PD). Short-term psychoanalytic psychotherapy (STPP) was found to be one treatment of choice for adolescents suffering from MDD.

Background: The first experimental study of transference work-in teenagers (FEST-IT) demonstrated the efficaciousness of transference work in STPP with adolescents suffering from MDD. The usefulness of STPP may be enhanced by exploring possible moderators.

Methods: Depressed adolescents (N = 69), aged 16-18 years, were diagnosed with the structured interview for DSM-IV PDs and randomized to 28 weeks of STPP with or without transference work. A mixed linear model was applied. The moderator effect was investigated by a three-way interaction including "time", "treatment group" and "number of PD criteria".

Results: A small but significant moderator effect was found for cluster B personality pathology. Patients with a higher number of cluster B PD criteria at baseline did better up to one-year post-treatment where therapists encouraged patients to explore the patient-therapist relationship in the here and now.

Conclusion: When treated with psychoanalytic psychotherapy for MDD, adolescents with cluster B PD symptoms seem to profit more from transference work than adolescents without such pathology.

Keywords: adolescent; depression; personality disorder; psychoanalytic psychotherapy; psychodynamic; transference.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Depressive Disorder, Major* / therapy
Diagnostic and Statistical Manual of Mental Disorders
Humans
Personality Disorders / diagnosis
Personality Disorders / therapy
Psychotherapy
Psychotherapy, Brief*
Treatment Outcome

Grants and funding

This research was funded by Vestfold Hospital Trust, The University of Oslo, Oslo University Hospital, The MRK Foundation and Josef and Haldis Andresens Legat. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.