Change in obsessive-compulsive and avoidant personality disorders following time-limited supportive-expressive therapy

Twenty-four patients with a DSM-III-R diagnosis of Avoidant Personality Disorder (AVPD) and 14 patients with a diagnosis of Obsessive-Compulsive Personality Disorder (OCPD) were assigned to 52 sessions of time-limited Supportive-Expressive (SE) dynamic psychotherapy. At intake, most patients had at least one concurrent Depressive and/or Anxiety disorder. OCPD patients lost their personality disorder diagnoses significantly faster than did AVPD patients. By the end of treatment, 39 percent of AVPD still retained their diagnosis while only 15 percent of OCPD did so. Using hierarchical linear modeling, both patient groups improved significantly across time on measures of personality disorders, depression, anxiety, general functioning, and interpersonal problems. OCPD patients remained in treatment significantly longer and tended to improve (nonsignificantly) more than did AVPD patients. Alliance ratings from both patients and therapists increased significantly over time, except for those of OCPD patients who remained constant.