Modified psychodynamic psychotherapy for patients with schizophrenia - a randomized controlled efficacy study (MPP-S study)

Prof. Dorothea von Haebler

Background of the study
Psychotherapy has been proven to be effective in the treatment of people with psychosis. Although psychodynamic psychotherapy for schizophrenic patients has been used successfully for decades, no systematic study that meets the applicable scientific criteria has yet been carried out.

Method
In a two-arm, prospective, single-blind, randomized controlled efficacy study, 120 patients with a diagnosis of schizophrenia or schizoaffective psychosis will be examined. Half of the subjects will be assigned to a group of patients who will receive 30 individual sessions of psychodynamic psychotherapy over the course of a year. A newly developed manual for psychodynamic psychotherapy will be used. The study therapists receive detailed instruction in this manual and regular supervision during their treatments. The second half of the subjects will be assigned to a control group (TAU) and will continue to receive their previous psychiatric treatment (without guideline psychotherapy).

Both groups also receive comprehensive diagnostics consisting of four study visits. The study visits contain a series of questionnaires, as well as interviews on psychosocial functioning and symptom severity, structure, mentalization and metacognition. They are conducted by psychiatrically and psychotherapeutically trained examiners. The audio recordings of the study visits and the study therapies are evaluated by a collective of assessors.

Aim of the study
The aim of the study is to examine the efficacy and safety of psychodynamic psychosis psychotherapy using a randomized controlled study design. The effects of psychodynamic psychotherapy on the psychosocial functioning level of the patients (primary study objective), the effects on the specific symptoms, on the need for hospital treatment, on the parameters of "psychic structure", metacognitive functions and the ability to mentalize, as well as the effects on the ability to solve interpersonal problems will be investigated.

In an exploratory part of the study, the subjects undergo an fMRI examination. In the course of the study, psychodynamic hypotheses in the treatment of psychosis will be tested.

Certain conditions must be met in order to participate in the study. The following inclusion and exclusion criteria were defined:

Inclusion criteria
Outpatients with:

• Diagnosis of schizophrenia or schizoaffective disorder according to DSM-IV-TR,
• Age 18-64 years
• Sufficient knowledge of the German language
• Written informed consent (DvH, ICH-GCP), including consent to audio recording of therapy sessions and study visits.
   

Exclusion criteria

• Organic brain disease or relevant severe somatic disease affecting cerebral function,
• Previous or current indication for primary addiction-specific treatment of alcohol or illicit drug disorders,
• Inability to understand the content and significance of the study and to give informed consent in writing,
• Marking of the suicidality item of the CDSS as greater than or equal to 2 at inclusion,
• Massively increased aggressiveness or current behavior that endangers others at inclusion.

Conclusion
The aim of the MPP-S study is to examine the efficacy and safety of psychodynamic psychosis psychotherapy. Since no systematic study that meets the current scientific criteria is available to date, the MPP-S study can make a significant contribution to psychodynamic psychotherapy research.

Original language: German, English

Marielle Büttner (IPU Berlin, Charité)
Katrin Becker (IPU Berlin)
Dajana Eder (HU Berlin)
Valentina Roth (Charité)

Project Start: 01/2015
Project End: 01/2026

AG Psychosenpsychotherapie an der Charité Berlin