Anxiety and Personality Problems Study (APS)

Financing by: DGPT / Stiftung zur Förderung der universitären Psychoanalyse

2011–2021 / Project Head: Prof. Dr. Dr. Dorothea Huber


Effectiveness, Sustainability and Efficiency of the Treatment of Anxiety and Personality Problems

There are various gaps in the research in the field of psychotherapeutic treatment of anxiety disorders

  • Lack of efficacy studies on the treatment of patients with anxiety disorders with systematic con-sideration of the high co-morbidity with this group of disorders;
  • Lack of studies to assess the sustainability of the effects of the anxiety treatments;
  • Lack of analysis of the long-term cost-benefit relations of anxiety treatments;
  • Lack of studies on differential indications.

The APS Study aims to close these gaps by comparing two methods for the treatment of patients with co-morbid anxiety disorders and personality problems, in a randomised controlled study design, in terms of their effectiveness, the sustainability of the changes achieved, as well as the cost-benefit relations in the context of the long-term study. The two forms of treatment to be assessed concern analytical psychotherapy and cognitive behavioural therapy.

Random Sample, Inclusion and Exclusion Criteria

The random sample should cover a total of 260 patients (130 per treatment method) and is to be conducted at four different study centres (Berlin, Hamburg, Heidelberg, Kassel, Munich). The diagnostic inclusion and exclusion criteria are based on the DSM-IV-TR Diagnostic and Statistical Manual of Mental Disorders classification system.

Inclusion Criteria

  • Panic disorder (with or without agoraphobia) and
  • At least one of the following personality disorders (PD): Avoidant, dependant, compulsive, depressive, passive-aggressive, histrionic or borderline PD; the latter only when it is not classified as acutely suicidal and treatable in an outpatient setting.
  • Age: At least 21 years old.

Exclusion Criteria

  • Bipolar affective disorder, psychotic disorders, acute eating disorders, disorders resulting from substance dependence (except caffeine or nicotine), Cluster A personality disorders (i.e. paranoid, suicidal and schizotypal PD), and antisocial PD.
  • Neurological diseases.
  • Minimal knowledge of German

Any psychopharmacological treatment does not represent an exclusion criteria (exception: Permanent treatment with benzodiazepines). Every psychiatric treatment, and especially medication and inpatient treatment, will be documented and taken into consideration subsequently as a covariate in the statistical evaluation.

Hypotheses

The hypotheses assume that both behavioural therapy as well as analytical psychotherapy yield significant improvements (benefits criterion), but that the improvements to the patients treated with analytical psychotherapy prove to be more stable in the long-term catamneses (which are uniform here six years after treatment begins regardless of the treatment form) due to the clearly higher treatment exposure, and especially for patients with multiple co-morbidity (necessity criterion), and that thus comparable cost-benefit relations are demonstrated in the two psychotherapeutic methods in the long-term catamneses (efficiency criterion).

APS Study Time Schedule

Complete study period: 10 years (Nov. 2011 to Oct. 2021)
In order to address the issue of the lasting effects of long-term treatments, a correspondingly extended time period is naturally required.

The time fields are intended to give a rough orientation. A period of some years is provided for the recruitment of the 260 study patients in total. The longer time periods after this result from the length of the long-term treatments (with a period of approx. 3 years assumed for analytical psychotherapy treatment) and at least a 3-year catamnesis period (or concluding survey six years after the commencement of treatment for all treatments respectively). Regardless of the length of the individual treatments, the complete survey time period amounts to six years after treatment commences. The continuation of the catamneses even with shorter treatments is highly important especially for the question of the efficiency. It is only possible to conduct a realistic comparison of the cost-benefit relations in this way.

Study Centres and Contact

Central study website: www.aps-studie.de and email: info(at)aps-studie.de

All of the current contacts and information are available here. This is intended to serve especially as an additional option after the ending of the treatment and the survey period following this and to ensure the mutual contacts between the various parties are maintained.

Leading Study Centres and Overall Coordination

Kassel
Head of Study: Prof. Dr. phil. Cord Benecke
Coordination: M. Sc. Psych. Miriam Hans
Institute for Psychology
Kassel University
Holländische Str. 36-38
34127 Kassel
Tel: 0561-804 7527
Email: miriam.hans(at)uni-kassel.de

Study Centres

Heidelberg
Head of Study: Prof. Dr. med. Henning Schauenburg
Coordination: Dipl.-Psych. Ottilia Klipsch
University Hospital Heidelberg
Clinic for General Internal Medicine and Psychosomatic Medicine
Thibautstr. 2
69115 Heidelberg
Tel: 06221-56 36317
Email: ottilia.klipsch(at)med.uni-heidelberg.de

Berlin
Head of Study: Prof. Dr. phil. Dr. med. Dorothea Huber, Prof. Dr. med. Heinrich Deserno
Coordination: Dipl. Psych. Svenja Over
Psychological Psychotherapist
IPU Berlin
Stromstr. 3
10555 Berlin
Tel.: 030-300 117 800
Email: svenja.over(at)ipu-berlin.de

Hamburg
Head of Study: Prof. Dr. phil. Silke Wiegand-Grefe
Coordination: M. Sc. Psych. Patrik Tessmann
MSH Medical School Hamburg
Am Kaiserkai 1
20457 Hamburg
Tel: 040-361 22 6457
(Reachable: Mon. & Wed. between 10.00 and 15.00)
Email: patrik.tessmann(at)medicalschool-hamburg.de

Munich
Head of Study: Prof. Dr. med. Dr. phil. Dorothea Huber
Coordination: Dr. phil. Dipl. Psych. Ingrid Erhardt
Klinikum rechts der Isar Clinic
Clinic and Polyclinic for Psychiatry and Psychotherapy
Institute Outpatient Department
Ismaningerstr. 22
81675 Munich
Tel: 0176-8694 1193 (mobile)
(Reachable: Mon., Wed., Thurs. between 10.00 and 14.00)
Email: ingrid.erhardt(at)tum.de

Further Information

Patient Info Sheet (PDF; in German)
Therapist Info Sheet (PDF; in German)