Forschungsprojekte der IPU

Die klinische Praxis und die Forschung

Inpatient Psychotherapy: Do Women and Men Experience the Same Therapy Differently?

2015–2017 / Leiterin: Prof. Dr. Dr. Dorothea Huber

Financed by: Third-party funding from the German Psychoanalytic Society (DPG)

Summary
Depressive illnesses are counted among the most frequent psychic disorders. In this regard, the prevalence is clearly higher among women (e.g. Busch et al., 2013) and a chronic disease progression occurs more often (e.g. Essau et al., 2010). Depressive women suffer more from accompanying anxieties, while depressive men by contrast suffer from comorbid addictions and their suicide rates are higher. There are differing symptom patterns with men and women, which potentially represent different subtypes of depression (Karger, 2014). While women appear to show more "classic" depressive symptoms, men tend e.g. to more aggression, risky behaviour, a reduction in contacts and substance abuse (Martin et al., 2013). Gender differences in the clinical pictures of depression are seen as a reason for the under-diagnosing of depression and the avoidance in using therapy among men and can also be accompanied by a differing experience of psychotherapy and a difference in the effectiveness of various forms of therapy.

In order to study this, data from the inpatient psychodynamic psychotherapy of depressive men (N=195) and women (N=453) are being evaluated and analysed with the gender differences in the symptomatology and accompanying interpersonal problems as well as in the effectiveness of the inpatient therapy, as indeed in the evaluation of various treatment aspects and forms of therapy (e.g. individual, group, creative therapies, etc.).

In spite of the sparse evidence overall on the effectiveness of inpatient psychodynamic therapy (Liebherz & Rabung, 2010), it proved possible to already validate its effectiveness in two prior studies on the inpatient therapy being assessed here (Huber et al., 2009; Herrmann & Huber, 2013). Interim analyses of a sub-sample indicate that gender differences can be explained in the change caused by a different symptomatology at the beginning of the therapy. Men and women seem to evaluate the treatment differently overall as being helpful. Analyses of the assessment of the various treatment options have still to be concluded.

Viewed from a more long-term perspective, the intention is to prospectively survey the differing forms of depression, and that especially based on the typology of the psychoanalyst S. Blatt, i.e. anaclitic versus introjective, and to examine their effect on the therapy success. Greater knowledge about differences and commonalities could be helpful with the question of the necessity for gender-sensitive psychotherapy with depression.

Talk
Fizke, E., Müller, A., Huber, D. (2016). Gender-Specific Aspects in Clinical Pictures and in Response to Inpatient Psychodynamic Psychotherapy with Depressive Patients. German College of Psychosomatic Medicine (DKPM) Annual Conference, March 2016, Potsdam.

Project Team
Prof. Dr. Dr. Dorothea Huber
International Psychoanalytic University
Stromstraße 3b, 10555 Berlin and
Klinik für Psychosomatische Medizin und Psychotherapie
Klinikum München/Clinic for Psychosomatic Medicine and Psychotherapy, Klinikum München-Harlaching Clinic
dorothea.huber(at)ipu-berlin.de

Dr. Axel Müller
Dr. Ella Fizke
Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum München/Clinic for Psychosomatic Medicine and Psychotherapy, Klinikum München-Harlaching Clinic

Literature
Blatt, S.J., Schaffer, C.E., Bers, S.A., & Quinlan, D.M. (1992): Psychometric properties of the Adolescent Depressive Experiences Questionnaire. Journal of Personality Assessment, 59, 82–98.
Busch, M.A., Maske, U.E., Ryl, L., Schlack, R. & Hapke, U. (2013). Prävalenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt 56, 733–739. doi: 10.1007/s00103-013-1688-3
Essau, C.A., Lewinsohn, P.M., Seeley, J.R., Sasagawa, S. (2010). Gender differences in the developmental course of depression. J Affect Disord 127, 185–190. doi:10.1016/j.jad.2010.05.016
Herrmann, A. S. & Huber, D. (2013). Was macht stationäre Psychotherapie erfolgreich? Der Einfluss von Patienten- und Behandlungsmerkmalen auf den Therapieerfolg in der stationären Psychotherapie. Z Psychosom Med Psychother 59, 273–289.
Huber, D., Albrecht, C., Henrich, G. & Klug, G. (2009). Langzeit-Katamnese zur Effektivität einer stationären psychodynamischen Psychotherapie. Zeitschrift für Psychosomatische Medizin und Psychotherapie, 55, 189-199.
Karger, A. (2014). Geschlechtsspezifische Aspekte bei depressiven Erkrankungen. Bundesgesundheitsblatt 57, 1092–1098. doi: 10.1007/s00103-014-2019-z
Liebherz, S. & Rabung, S. (2013). Wirksamkeit psychotherapeutischer Krankenhausbehandlung im deutschsprachigen Raum. Eine Meta-Analyse. Psychoth Psych Med 63. 355-364. Doi: 10.1055/s-0033-1337909
Martin, L.A., Neighbors, H.W., & Griffith, D.M. (2013). The experience of symptoms of depression in men vs women: analysis of the national comorbidity survey replication. JAMA Psychiatry 70, 1100–1106. doi:10.1001/jamapsychiatry.2013.1985.