Personality Disorders and Long-Term Outcome After Brief Dynamic Psychotherapy

In a sample of 45 outpatients treated with dynamic psychotherapy of brief to moderate length (9—53 sessions), the subsample of patients with personality disorders (n = 15) showed significantly less symptomatic and dynamic change 2 years after therapy compared to the subsample of patients without such disorders (n = 30). At 4 years' follow-up, the differences in mean changes between the two subsamples were nonsignificant. However, for patients with personality disorders, the number of treatment sessions was significantly related to acquisition of insight 2 years after therapy and to overall dynamic change 4 years after therapy, whereas for patients without personality disorders, there were no such relationships. For patients with personality disorders, length of treatment seemed more essential for long-term dynamic improvement than patient characteristics such as suitability, cluster category, or initial health-sickness. Very small long-term dynamic changes were observed after a brief, focused treatment approach for patients with personality disorders, but significant long-term dynamic changes were observed after those treatments that lasted 30 sessions or more.