Wirksamkeit stationärer psychodynamischer Psychotherapie bei Depressionen

Background The effectiveness of psychodynamic psychotherapy on clinical outcome variables, such as depressive symptom load is proven; however, there is still a lack of studies documenting the effectiveness of psychodynamic clinical inpatient treatment on psychodynamically relevant outcome measures. Method Within a naturalistic multicenter study "Inpatient psychodynamic oriented psychotherapy of depressive disorders (STOP-D)" the effectiveness of psychodynamic inpatient psychotherapy on the adaptivity of defence organization (inventory of personality organization, IPO) and the personality structural resources to handle conflicts (Heidelberg restructuring scale, HUS) was analyzed. Female inpatients with depressive symptoms from 15 psychosomatic hospital units were included in the study. The mean treatment duration was 61.8 days. Data acquisition was implemented at admission (T1;n & x202f;= 474), discharge (T2;n & x202f;= 432) and a 6-month follow-up after discharge (T3;n & x202f;= 286). Results There are indications of the effectiveness on the psychodynamically relevant outcome variables investigated. In addition to the known clear improvement of clinical symptom load, low-grade to high-grade effect sizes on psychodynamic core variables also became apparent. The alterations remained stable at the catamnesis. Conclusion The effectiveness of psychodynamic inpatient psychotherapy on the typical depressive symptom load seems to be associated with a long-lasting increase of structural resources of personality and might facilitate a more adaptive coping of imminent conflicts and stresses even after discharge

A novel type of macrothrombocytopenia associated with a defect in alpha2,3-sialylation

Item does not contain fulltextWe describe a novel type of human thrombocytopenia characterized by the appearance of giant platelets and variable neutropenia. Searching for the molecular defect, we found that neutrophils had strongly reduced sialyl-Lewis X and increased Lewis X surface expression, pointing to a deficiency in sialylation. We show that the glycosylation defect is restricted to alpha2,3-sialylation and can be detected in platelets, neutrophils, and monocytes. Platelets exhibited a distorted structure of the open canalicular system, indicating defective platelet generation. Importantly, patient platelets, but not normal platelets, bound to the asialoglycoprotein receptor (ASGP-R), a liver cell-surface protein that removes desialylated thrombocytes from the circulation in mice. Taken together, this is the first type of human thrombocytopenia in which a specific defect of alpha2,3-sialylation and an induction of platelet binding to the liver ASGP-R could be detected