Multi-Level Outcome Study of Psychoanalyses of Chronically Depressed Patients with Early Trauma (MODE)

About the Program

The Multi-Level Outcome Study of Psychoanalyses of Chronically Depressed Patients with Early Trauma (MODE) is a follow-up to the large multicenter LAC Depression Study, which compared psychoanalytic and cognitive-behavioral long-term therapies in chronically depressed patients (Leuzinger-Bohleber et al, 2019 a, b). An unexpected finding was that over 80% of the chronically depressed patients had suffered from severe early childhood trauma. In the LAC study, it was up to the analysts to decide the weekly frequency of sessions with these severely ill patients. It was found that the early traumatized patients showed especially good results with high frequency treatments. Therefore, this observation will be investigated more systematically in MODE.

MODE investigates the outcomes of high and lower frequency psychoanalytic treatments for this specific patient population of chronically depressed individuals who have experienced severe childhood trauma. The major hypothesis is that for this group of patients, intensive frequent treatment produces demonstrably better outcomes, achieved more rapidly, in comparison to less frequent psychoanalytic treatment. Outcome measures include both depressive symptoms severity and MRI-based brain measures. Treatment progress will be followed in relation to symptom reduction (using standard psychological measures), structural change (defined by psychoanalytic methods), and neurobiological change (assessed using MRI).

Prof. Dr. Leuzinger-Bohleber will give an overview of the historical, institutional and conceptual background of the study, the design, the problematic nature of psychoanalytic manuals and the state of the study. We have screened more than 90 patients as of November 2021. More than 50 patients are now in psychoanalyses. A detailed case study will be used to illustrate, among other things, why the MODE design has been shown to be particularly suitable for chronically ill patients between the ages of 20 and 30 who suffer from characteristic conflicts of so called “emergent adulthood.” Dreams illustrate that psychoanalysis offers a unique opportunity to therapeutically process a developmental stand-still in this age group.

Dr. Lane, a consultant to the MODE study, will focus his remarks on how memory reconsolidation applies to psychotherapy and psychoanalysis. He will discuss the opportunities and challenges in testing the memory reconsolidation hypothesis as a mechanism of enduring change, on how psychoanalytic treatments may promote reconsolidation of early life trauma memories, and on using dream reports as an outcome measure.