[Interdisciplinary, collaborative D-A-CH (Germany, Austria and Switzerland) consensus statement concerning the diagnostic and treatment of myalgic encephalomyelitis/chronic fatigue syndrome].

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe, chronic multisystemic disease which, depending on its severity, can lead to considerable physical and cognitive impairment, loss of ability to work and the need for nursing care including artificial nutrition and, in very severe cases, even death.The aim of this D-A-CH (Germany, Austria, Switzerland) consensus statement is 1) to summarize the current state of knowledge on ME/CFS, 2) to highlight the Canadian Consensus Criteria (CCC) as clinical criteria for diagnostics with a focus on the leading symptom post-exertional malaise (PEM) and 3) to provide an overview of current options and possible future developments, particularly with regard to diagnostics and therapy. The D-A-CH consensus statement is intended to support physicians, therapists and valuer in diagnosing patients with suspected ME/CFS by means of adequate anamnesis and clinical-physical examinations as well as the recommended clinical CCC, using the questionnaires and other examination methods presented.

The Role of Psychotherapy in the Care of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Myalgic encephalomyelitis/chronic fatigue (ME/CFS) is a post-infectious, chronic disease that can lead to severe impairment and, even, total disability. Although the disease has been known for a long time, and has been coded in the ICD since 1969 (G93.3), medical research has not yet been able to reach a consensus regarding its physiological basis and how best to treat it.

Self-report and observer ratings of personality functioning: a study of the OPD system.

Recent considerations around DSM-5 criteria of personality disorders (PDs) demand new concepts of assessing levels of personality functioning. Of special interest are multiperspective approaches accounting for clinicians' as well as patients' points of view. The study investigates observer-rated and self-assessed levels of personality functioning measured by the level of structural integration as defined by the Operationalized Psychodynamic Diagnosis System (OPD).

[Structural change as an outcome paradigm in psychodynamic psychotherapy - results of the PAL-Study (long-term psychoanalytic psychotherapy study].

Objective: Psychodynamic psychotherapies have proved to lead to relevant symptomatic improvement. An unresolved question, however, is what amount of psychodynamic change can be expected beyond symptom relief. For theoretical and methodological reasons rooted in the psychodynamic approach, this question has been difficult to answer until now.

[The OPD Structure Questionnaire (OPD-SQ): first results on reliability and validity].

The concept of psychic structure plays a central role in the Operationalised Psychodynamic Diagnosis (OPD) system. Until recently, its reliable and valid assessment had to be based on expert ratings of clinical interviews, limiting the use of the OPD in routine measurements and research, and excluding the patients' perspective. The current study describes the development and evaluation of a questionnaire on the OPD structure axis (OPD-SQ) in several clinical and non-clinical samples (N = 1 112).

A longitudinal study of emotional experience, expressivity, and psychopathology in psychotherapy inpatients and psychologically healthy persons.

The authors investigated changes of emotional experience and expressivity in 34 inpatients undergoing psychodynamic therapy and in 29 healthy persons who were assessed at parallel time intervals. Participants completed 2 measures of psychopathology (Symptom Checklist-90 Revised and Inventory of Interpersonal Problems-64) and took part in relationship episode interviews. The emotional experiences they reported and their nonverbal emotional expressivity during the interviews were assessed by independent raters.

Structural change as a predictor of long-term follow-up outcome.

Based on data from psychoanalytic long-term psychotherapies, the predictive value of three measures of pre-post change for retrospective patient assessments of outcome at 1-year and 3-year follow-up was investigated. Pre-post changes were measured using the Global Severity Index (GSI), the Inventory of Interpersonal Problems (IIP) total score, and the Heidelberg Structural Change Scale (HSCS). In line with psychoanalytic theory, it was assumed that structural changes cause especially persistent changes and would, therefore, be most suitable to predict the follow-up criterion.

Educational multidisciplinary training programme for patients with chronic pruritus.

Chronic pruritus (> 6 weeks) is a worldwide symptom and a burden in many dermatological, systemic and psychosomatic/psychiatric diseases. Patients with chronic pruritus frequently endure a long and complicated disease course, failure of therapy and a substantial reduction in quality of life. Psychological mechanisms may be involved in eliciting and coping with chronic pruritus.

[How do conflict and structure present themselves in relationships?].

It is argued that the approaches used up to now for analyzing dysfunctional relationship patterns are more or less explicitly based on a conflict model and therefore not adequate for describing relationships characterized by structural impairments of a patient's personality. Using the concepts of conflict and structure as derived from the Operationalized Psychodynamic Diagnostic system (OPD-2), four principles of a dysfunctional relationship formation are discussed. It is shown that the differentiation of conflict- and structure-related pathology is highly significant with regard to the selection of an appropriate psychotherapeutic strategy.

[Results of psychoanalytic long-term therapy in specific diagnostic groups: improvement in symptoms and interpersonal relationships].

Objectives: In the present paper, data from four German studies on the efficacy of outpatient psychoanalytic long-term psychotherapy were examined for symptom reduction (SCL-90-R) and reduction of interpersonal problems (IIP-D). Specifically, the research question addressed the efficacy of long-term therapy in specific diagnostic groups and was was compared with that of a parallel group who underwent shorter-term psychodynamic therapy.

Methods: Data from four German studies addressing the efficacy of outpatient psychoanalytic long-term therapy were collected.

[How are dysfunctional relationship patterns re-enacted in the therapist-patient interaction?].

Using Structural Analysis of Social Behaviour (SASB), the communicative means by which a patient succeeds in re-enacting his or her own maladaptive relationship patterns in the interaction with the therapist is examined. This line of investigation stems from the work of Henry and co-workers, who have shown that therapists often unknowingly allow themselves to be drawn into subtly hostile interactions with patients, and that such interactions are associated with a negative outcome. In a mixed quantitative-qualitative single case study, the relationship narratives of a female patient from two therapy sessions are analysed using a cluster-analytic procedure in order to identify her repetitive relationship patterns.

[Changes in emotional experience during the course of psychoanalytic therapy].

Objectives: Does the subjective emotional experience of patients change in the course of psychoanalytic treatment?

Methods: Ten patients were interviewed four times during their first two years in psychoanalytic therapy. Interviews were coded with regard to the patients' subjective emotional experience. Changes in individual emotion profiles were then tested for associations with therapy outcome using a hierarchical linear model.

[New diagnostic alternatives for dysfunctional relationships: the relationship axis of the OPD-2].

As a part of the new version of Operationalized Psychodynamic Diagnosis (OPD-2), the relationship axis is introduced which was developed on the basis of research and clinical work with the OPD-1. It provides a procedure indicating dysfunctional relationship patterns. The new version is characterized by the following qualities: The relationship axis is based more consequently on the circumplex model of interpersonal behaviour.

[The clinical emotions list - a procedure for assessing patients' affective repertoires].

Using 20 video-interviews with psychosomatic outpatients we developed a category system that should allow a differentiated and complete assessment of a person's affective repertoire. In doing so we considered the psychological literature on verbal expression of emotions. Semantic construction, distinguishing emotion categories from one another, was chosen as the main criterion for coding.

Do interpersonal behavior and emotional experience change in the course of successful long-term psychoanalytic therapies?

The way in which patients behave toward others is considered to be a correlate of mental health and thus of successful psychotherapy. Until now, research regarding the extent to which this assumption is justified has produced contradictory findings. On the basis of 2 definitions of normal interpersonal behavior (Benjamin, 1993; Crits-Christoph, Demorest, Muenz, & Baranackie, 1994), the authors studied 10 patients undergoing psychoanalytic therapy to determine whether changes in their descriptions of interpersonal relationships were associated with a decrease in self-reported symptoms and interpersonal problems during the first 2 years of treatment.