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Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis
- Authors:
- LEICHSENRING Falk, RABUNG Sven
- Journal article citation:
- British Journal of Psychiatry, 199(1), July 2011, pp.15-22.
- Publisher:
- Cambridge University Press
Psychodynamic psychotherapy is an umbrella concept encompassing treatments that include supportive-interpretive psychotherapeutic interventions. This meta-analysis focused on its use in complex mental disorders (defined as personality disorders, chronic mental disorders or multiple mental disorders). A literature search was used to identify relevant studies, and 10 controlled trial studies were identified as meeting the inclusion criteria, including psychodynamic psychotherapy lasting for at least one year or 50 sessions. The article discusses the analysis of the studies, including comparison of the effects of long-term psychodynamic psychotherapy with other forms of psychotherapy. The authors conclude that the analysis showed that long-term psychodynamic psychotherapy was superior to less intensive methods of psychotherapy in complex mental disorders, and that there were positive correlations between outcome and duration of therapy. They note that further research on long-term psychotherapy is needed.
Prevalence of personality disorders in the general adult population in Western countries: systematic review and meta-analysis
- Authors:
- VOLKERT Jana, GABLONSKI Thorsten-Christian, RABUNG Sven
- Journal article citation:
- British Journal of Psychiatry, 213(6), 2018, pp.709-715.
- Publisher:
- Cambridge University Press
Background: Personality disorder is a severe health issue. However, the epidemiology of personality disorders is insufficiently described and surveys report very heterogeneous rates. Aims: We aimed to conduct a meta-analysis on the prevalence of personality disorders in adult populations and examine potential moderators that affect heterogeneity. Method: The authors searched PsycINFO, PSYNDEX and Medline for studies that used standardised diagnostics (DSM-IV/-5, ICD-10) to report prevalence rates of personality disorders in community populations in Western countries. Prevalence rates were extracted and aggregated by random-effects models. Meta-regression and sensitivity analyses were performed and publication bias was assessed. Results: The final sample comprised ten studies, with a total of 113 998 individuals. Prevalence rates were fairly high for any personality disorder (12.16%; 95% CI, 8.01–17.02%) and similarly high for DSM Clusters A, B and C, between 5.53 (95% CI, 3.20–8.43%) and 7.23% (95% CI, 2.37–14.42%). Prevalence was highest for obsessive–compulsive personality disorder (4.32%; 95% CI, 2.16–7.16%) and lowest for dependent personality disorder (0.78%; 95% CI, 0.37–1.32%). A low prevalence was significantly associated with expert-rated assessment (versus self-rated) and reporting of descriptive statistics for antisocial personality disorder. Conclusions: Epidemiological studies on personality disorders in community samples are rare, whereas prevalence rates are fairly high and vary substantially depending on samples and methods. Future studies investigating the epidemiology of personality disorders based on the DSM-5 and ICD-11 and models of personality functioning and traits are needed, and efficient treatment should be a priority for healthcare systems to reduce disease burden. (Edited publisher abstract)