Modified Psychodynamic Psychotherapy for Patients with Schizophrenia – a Randomised-Controlled Efficacy Study (MPP-S Study)

Project Heads: Prof. Dr. Dorothea von Haebler, IPU; Dr. Christiane Montag, Charité Berlin; Dr. Günter Lempa, Munich
Financed by: Stiftung Charité foundation, German Society for Psychoanalysis, Psychotherapy and Psychosomatics (DGPT), IPU funding, Köhler Foundation

2015–2018 / Project Heads: Prof. Dr. Dorothea von Haebler, Dr. Christiane Montag, Dr. Günter Lempa


Study Background

Psychotherapy is demonstrably effective in the therapy of people with psychoses. Although the psychodynamic psychotherapy of schizophrenic patients has been applied successfully for decades, there has been no systematic study to date that fulfils the prevailing scientific criteria.

Method

In a two-branched, prospective, single-blind and randomised-controlled efficacy study, 120 patients diagnosed with schizophrenia or a schizoaffective psychosis are being studied. Half of the test persons has been allocated to a patient group who are receiving 30 individual psychodynamic psychotherapy sessions over the course of one year. A newly developed manual on psychodynamic psychotherapy is being applied here. The study therapists receive detailed instructions in this manual and regular supervision during their treatment work. The second half of the test persons has been allocated to a control group (TAU) and is continuing to retain the psychiatric treatment to date (without any psychotherapy guidelines).

In addition, both groups are receiving extensive diagnostics, consisting of four study visits. The study visits include a range of questionnaires, as well as interviews on the psychosocial functioning level and on the symptom severity, as well as on the structure, mentalisation and metacognition. They are being conducted by examiners trained in psychiatric psychotherapy. The audio recordings of the study visits and the study therapies are being evaluated by a collective body of assessors.

Aim of the Study

The aim of the study is to assess the effectiveness and soundness of psychodynamic psychosis psychotherapy on the basis of a randomised-controlled study design. The study is examining the effects of psychodynamic psychotherapy on the psychosocial functioning level of the patients (primary study aim), the effects on the specific symptoms, on the need to have hospital treatment, on the "psychic structure", the metacognitive functions and the mentalisation ability parameters, as well as the effects on the ability to solve interpersonal problems.

In an explorative part of the study, the test persons are undergoing an fMRT examination. The intention is this regard is to assess psychodynamic hypotheses in the treatment of psychoses over the course of the study.

Specific participation conditions were set in order to be permitted to participate in the study. The following have been defined as the inclusion and exclusion criteria:

Inclusion criteria

Patients treated in an outpatient setting who have been:

  • Diagnosed with schizophrenia or a schizoaffective disorder in accordance with DSM-IV-TR,
  • Aged between18-64,
  • Sufficient knowledge of German,
  • Informed written consent (DoH, ICH-GCP), including their agreement to the sound recordings of the therapy sessions and study visits.

Exclusion criteria

  • Organic brain disease or relevant severe somatic illness with an effect on the cerebral function,
  • Prior or current indications of primarily addiction-specific treatment for disorders due to alcohol or illegal drugs,
  • Inability to understand the content and meaning of the study and to provide informed written consent,
  • CDSS suicide item score greater than or equal to 2 on their inclusion,
  • Massively increased aggression or current behaviour endangering to other persons on their inclusion.

Conclusion

The MPP-S Study aims to examine the effectiveness and soundness of psychodynamic psychosis psychotherapy. As no systematic study has been conducted here to date, which fulfils the prevailing scientific criteria, the MPP-S Study is capable of making a fundamental contribution to psychodynamic psychotherapy research.