Deliberate self-harm in female patients with affective disorders: investigation of personality structure and affect regulation by means of operationalized psychodynamic diagnostics.

This study investigated psychodynamically relevant dimensions in female depressive patients with and without deliberate self-harm (DSH). DSH is often observed in depressive patients and frequently shows a correlation with personality disorders. Forty female depressive patients with and without DSH were investigated after recovery from acute depressive pathology by means of "operationalized psychodynamic diagnostics" (OPD). Patients with DSH had a significantly lower level of integration in the OPD dimension "structure," and their "interpersonal relationships" showed dysfunctional interaction patterns. They also had a significantly higher rate of personality disorders. These results underline the significance of aspects of personality structure in female depressive patients with DSH, and enable a deeper understanding of their dysfunctional defense strategies, the connections with underlying disturbed affect regulation, and vicious circles in the therapeutic transference-countertransference relationship. OPD has been shown to be a useful tool for empirical research into therapeutically relevant dimensions of personality.

Impaired rapid modulation of cerebral hemodynamics during a planning task in schizophrenia.

OBJECTIVE: Patients with schizophrenia show deficits in planning, and the Stockings of Cambridge (SOC) is a task that assesses planning performance. This study was undertaken to investigate rapid changes of cerebral hemodynamics during separate phases of SOC in schizophrenia and normals by means of functional transcranial Doppler sonography (fTCD). METHODS: We included 21 patients with chronic schizophrenia and a control group of 20 healthy subjects in the study. They underwent fTCD of the middle (MCA) and anterior cerebral arteries (ACA) during performance of SOC. RESULTS: The main finding was that healthy subjects significantly modulated the early cerebral hemodynamic response along distinct conditions of SOC, whereas we observed no significant differences in patients. Normally, there was an up-regulation of cerebral hemodynamics during mental planning, and about zero values were observed during movement execution. Patients showed lower development of the early cerebral hemodynamic response during planning of SOC. CONCLUSIONS: The findings of this study suggest a uniform pattern of cerebral hemodynamic regulation during a planning task in schizophrenia, whereas healthy subjects modulated such a response along a planning-movement execution sequence. SIGNIFICANCE: We provide novel evidence that modulation of cerebral hemodynamics is compromised in schizophrenia, and that fTCD constitutes a proper method to measure these alterations.

[Automutilistic behaviour in female patients with affective disorders: investigation of personality structure and affect regulation by means of Operationalized Psychodynamic Diagnostics (OPD)]. / Automutilistisches Verhalten bei Patientinnen mit affektiven Störungen: Untersuchung der Persönlichkeitsstruktur und Affektregulation mittels Operationalisierter Psychodynamischer Diagnostik (OPD).

UNLABELLED: Automutilistic behaviour is frequently correlated with personality disorders and should be differentiated from suicidal behaviour during acute episodes of affective disorders. The aim of the study was to investigate psychotherapeutically and psychodynamically significant personality traits and affect regulation. The dimensions "relationship", "conflict" and "structure" were examined by means of Operationalized Psychodynamic Diagnostics. SAMPLE: 20 female patients with depression and automutilistic behaviour and 20 age-matched female subjects with a similar educational background, suffering from depression without automutilistic behaviour. RESULTS The female patients with depression and automutilistic behaviour could be differentiated from the control group in all categories in the OPD dimension "structure". They showed an "isolated" and "disclosed" self-image. This negative self-perception corresponded with a negative countertransference. There were no differences between the patients with automutilistic behaviour and the control group regarding the OPD dimension "conflict". Low and moderate levels of integration were prominently correlated with the autonomy-dependence conflict. CONCLUSION The results underline the significance of aspects of personality structure in automutilistic behaviour seen in female patients with depression. Operationalized Psychodynamic Diagnostics can reveal therapeutically relevant personality dimensions for empirical research.