Author: OPD-CA-2 Task Force
Publisher: Hogrefe Publishing GmbH
ISBN: 1616764899
Category : Medical
Languages : en
Pages : 350
Book Description
OPD-CA-2, the multiaxial diagnostic system for psychodynamically oriented psychiatrists and therapists, now for children and adolescents. Following the success of the Operationalized Psychodynamic Diagnosis for Adults (OPD-2), this multiaxial diagnostic and classification system based on psychodynamic principles has now been adapted for children and adolescents by combining psychodynamic, developmental, and clinical psychiatric perspectives. The OPD-CA-2 is based on four axes that are aligned with the new dimensional approach in the DSM-5: I = interpersonal relations, II = conflict, III = structure, and IV = prerequisites for treatment. After an initial interview, the clinician (or researcher) can evaluate the patient's psychodynamics according to these axes to get a comprehensive psychodynamic view of the patient. Easy-to-use checklists and evaluation forms are provided. The set of tools and procedures the OPD-CA-2 manual provides have been widely used for assessing indications for therapy, treatment planning, and measuring change, as well as providing information for parental work.
OPD-CA-2 Operationalized Psychodynamic Diagnosis in Childhood and Adolescence
Author: OPD-CA-2 Task Force
Publisher: Hogrefe Publishing GmbH
ISBN: 1616764899
Category : Medical
Languages : en
Pages : 350
Book Description
OPD-CA-2, the multiaxial diagnostic system for psychodynamically oriented psychiatrists and therapists, now for children and adolescents. Following the success of the Operationalized Psychodynamic Diagnosis for Adults (OPD-2), this multiaxial diagnostic and classification system based on psychodynamic principles has now been adapted for children and adolescents by combining psychodynamic, developmental, and clinical psychiatric perspectives. The OPD-CA-2 is based on four axes that are aligned with the new dimensional approach in the DSM-5: I = interpersonal relations, II = conflict, III = structure, and IV = prerequisites for treatment. After an initial interview, the clinician (or researcher) can evaluate the patient's psychodynamics according to these axes to get a comprehensive psychodynamic view of the patient. Easy-to-use checklists and evaluation forms are provided. The set of tools and procedures the OPD-CA-2 manual provides have been widely used for assessing indications for therapy, treatment planning, and measuring change, as well as providing information for parental work.
Publisher: Hogrefe Publishing GmbH
ISBN: 1616764899
Category : Medical
Languages : en
Pages : 350
Book Description
OPD-CA-2, the multiaxial diagnostic system for psychodynamically oriented psychiatrists and therapists, now for children and adolescents. Following the success of the Operationalized Psychodynamic Diagnosis for Adults (OPD-2), this multiaxial diagnostic and classification system based on psychodynamic principles has now been adapted for children and adolescents by combining psychodynamic, developmental, and clinical psychiatric perspectives. The OPD-CA-2 is based on four axes that are aligned with the new dimensional approach in the DSM-5: I = interpersonal relations, II = conflict, III = structure, and IV = prerequisites for treatment. After an initial interview, the clinician (or researcher) can evaluate the patient's psychodynamics according to these axes to get a comprehensive psychodynamic view of the patient. Easy-to-use checklists and evaluation forms are provided. The set of tools and procedures the OPD-CA-2 manual provides have been widely used for assessing indications for therapy, treatment planning, and measuring change, as well as providing information for parental work.
Psychodynamic Diagnostic Manual
Author: Vittorio Lingiardi
Publisher: Guilford Publications
ISBN: 1462530567
Category : Psychology
Languages : en
Pages : 1106
Book Description
Now completely revised (over 90% new), this is the authoritative diagnostic manual grounded in psychodynamic clinical models and theories. Explicitly oriented toward case formulation and treatment planning, PDM-2 offers practitioners an empirically based, clinically useful alternative or supplement to DSM and ICD categorical diagnoses. Leading international authorities systematically address personality functioning and psychological problems of infancy, childhood, adolescence, adulthood, and old age, including clear conceptualizations and illustrative case examples. Purchasers get access to a companion website where they can find additional case illustrations and download and print five reproducible PDM-derived rating scales in a convenient 8 1/2" x 11" size. New to This Edition *Significant revisions to all chapters, reflecting a decade of clinical, empirical, and methodological advances. *Chapter with extended case illustrations, including complete PDM profiles. *Separate section on older adults (the first classification system with a geriatric section). *Extensive treatment of psychotic conditions and the psychotic level of personality organization. *Greater attention to issues of culture and diversity, and to both the clinician's and patient's subjectivity. *Chapter on recommended assessment instruments, plus reproducible/downloadable diagnostic tools. *In-depth comparisons to DSM-5 and ICD-10-CM throughout. Sponsoring associations include the International Psychoanalytical Association, Division 39 of the American Psychological Association, the American Psychoanalytic Association, the International Association for Relational Psychoanalysis & Psychotherapy, the American Association for Psychoanalysis in Clinical Social Work, and five other organizations. Winner--American Board and Academy of Psychoanalysis Book Prize (Clinical Category)
Publisher: Guilford Publications
ISBN: 1462530567
Category : Psychology
Languages : en
Pages : 1106
Book Description
Now completely revised (over 90% new), this is the authoritative diagnostic manual grounded in psychodynamic clinical models and theories. Explicitly oriented toward case formulation and treatment planning, PDM-2 offers practitioners an empirically based, clinically useful alternative or supplement to DSM and ICD categorical diagnoses. Leading international authorities systematically address personality functioning and psychological problems of infancy, childhood, adolescence, adulthood, and old age, including clear conceptualizations and illustrative case examples. Purchasers get access to a companion website where they can find additional case illustrations and download and print five reproducible PDM-derived rating scales in a convenient 8 1/2" x 11" size. New to This Edition *Significant revisions to all chapters, reflecting a decade of clinical, empirical, and methodological advances. *Chapter with extended case illustrations, including complete PDM profiles. *Separate section on older adults (the first classification system with a geriatric section). *Extensive treatment of psychotic conditions and the psychotic level of personality organization. *Greater attention to issues of culture and diversity, and to both the clinician's and patient's subjectivity. *Chapter on recommended assessment instruments, plus reproducible/downloadable diagnostic tools. *In-depth comparisons to DSM-5 and ICD-10-CM throughout. Sponsoring associations include the International Psychoanalytical Association, Division 39 of the American Psychological Association, the American Psychoanalytic Association, the International Association for Relational Psychoanalysis & Psychotherapy, the American Association for Psychoanalysis in Clinical Social Work, and five other organizations. Winner--American Board and Academy of Psychoanalysis Book Prize (Clinical Category)
Anorexia Nervosa
Author: Hans-Christoph Friederich
Publisher: Hogrefe Publishing GmbH
ISBN: 1616765542
Category : Psychology
Languages : en
Pages : 141
Book Description
This manual presents an evidence-based focal psychodynamic approach for the outpatient treatment of adults with anorexia nervosa, which has been shown to produce lasting changes for patients. The reader first gains a thorough understanding of the general models and theories of anorexia nervosa. The book then describes in detail a three-phase treatment using focal psychodynamic psychotherapy. It provides extensive hands-on tips, including precise assessment of psychodynamic themes and structures using the Operationalized Psychodynamic Diagnosis (OPD) system, real-life case studies, and clinical pearls. Clinicians also learn how to identify and treat typical ego structural deficits in the areas of affect experience and differentiation, impulse control, self-worth regulation, and body perception. Detailed case vignettes provide deepened insight into the therapeutic process. A final chapter explores the extensive empirical studies on which this manual is based, in particular the renowned multicenter ANTOP study. Printable tools in the appendices can be used in daily practice. This book is of interest to clinical psychologists, psychotherapists, psychiatrists, counselors, and students.
Publisher: Hogrefe Publishing GmbH
ISBN: 1616765542
Category : Psychology
Languages : en
Pages : 141
Book Description
This manual presents an evidence-based focal psychodynamic approach for the outpatient treatment of adults with anorexia nervosa, which has been shown to produce lasting changes for patients. The reader first gains a thorough understanding of the general models and theories of anorexia nervosa. The book then describes in detail a three-phase treatment using focal psychodynamic psychotherapy. It provides extensive hands-on tips, including precise assessment of psychodynamic themes and structures using the Operationalized Psychodynamic Diagnosis (OPD) system, real-life case studies, and clinical pearls. Clinicians also learn how to identify and treat typical ego structural deficits in the areas of affect experience and differentiation, impulse control, self-worth regulation, and body perception. Detailed case vignettes provide deepened insight into the therapeutic process. A final chapter explores the extensive empirical studies on which this manual is based, in particular the renowned multicenter ANTOP study. Printable tools in the appendices can be used in daily practice. This book is of interest to clinical psychologists, psychotherapists, psychiatrists, counselors, and students.
Psychodynamic Diagnostic Manual (PDM)
Author: American Psychoanalytic Association
Publisher: Psychodynamic Diagnostic Manual
ISBN:
Category : Medical
Languages : en
Pages : 888
Book Description
This manual is based on current neuroscience and treatment outcome studies that demonstrate the importance of focusing on the full range and depth of emotional and social functioning. Beginning with a classification of the spectrum of personality patterns and disorders found in individuals and then describing a profile of mental functioning that permits a clinician to look in detail at each of the patient's capacities, the entries include a description of the patient's symptoms with a focus on the patient's internal experiences as well as surface behaviors. Intended to expand on the DSM (Diagnostic and Statistical Manual of Mental Disorders)and ICD (International Statistical Classification of Diseases and Related Health Problems) efforts in cataloging the symptoms and behaviors of mental health patients, this manual opens the door to a fuller understanding of the functioning of the mind, brain, and their development.
Publisher: Psychodynamic Diagnostic Manual
ISBN:
Category : Medical
Languages : en
Pages : 888
Book Description
This manual is based on current neuroscience and treatment outcome studies that demonstrate the importance of focusing on the full range and depth of emotional and social functioning. Beginning with a classification of the spectrum of personality patterns and disorders found in individuals and then describing a profile of mental functioning that permits a clinician to look in detail at each of the patient's capacities, the entries include a description of the patient's symptoms with a focus on the patient's internal experiences as well as surface behaviors. Intended to expand on the DSM (Diagnostic and Statistical Manual of Mental Disorders)and ICD (International Statistical Classification of Diseases and Related Health Problems) efforts in cataloging the symptoms and behaviors of mental health patients, this manual opens the door to a fuller understanding of the functioning of the mind, brain, and their development.
Operationalized Psychodynamic Diagnosis OPD-2
Author: OPD Task Force
Publisher: Hogrefe Publishing GmbH
ISBN: 1616763531
Category : Psychology
Languages : en
Pages : 432
Book Description
Operationalized Psychodynamic Diagnosis (OPD) is a form of multiaxial diagnostic and classification system based on psychodynamic principles, analogous to those based on other principles such as DSM-IV and ICD-10. The OPD is based on five axes: I = experience of illness and prerequisites for treatment, II = interpersonal relations, III = conflict, IV = structure, and V = mental and psychosomatic disorders (in line with Chapter V (F) of the ICD-10). After an initial interview lasting 1–2 hours, the clinician (or researcher) can evaluate the patient's psychodynamics according to these axes and enter them in the checklists and evaluation forms provided. The new version, OPD-2, has been developed from a purely diagnostic system to include a set of tools and procedures for treatment planning and for measuring change, as well as for determining the appropriate main focuses of treatment and developing appropriate treatment strategies.
Publisher: Hogrefe Publishing GmbH
ISBN: 1616763531
Category : Psychology
Languages : en
Pages : 432
Book Description
Operationalized Psychodynamic Diagnosis (OPD) is a form of multiaxial diagnostic and classification system based on psychodynamic principles, analogous to those based on other principles such as DSM-IV and ICD-10. The OPD is based on five axes: I = experience of illness and prerequisites for treatment, II = interpersonal relations, III = conflict, IV = structure, and V = mental and psychosomatic disorders (in line with Chapter V (F) of the ICD-10). After an initial interview lasting 1–2 hours, the clinician (or researcher) can evaluate the patient's psychodynamics according to these axes and enter them in the checklists and evaluation forms provided. The new version, OPD-2, has been developed from a purely diagnostic system to include a set of tools and procedures for treatment planning and for measuring change, as well as for determining the appropriate main focuses of treatment and developing appropriate treatment strategies.
Operationalized Psychodynamic Diagnostics
Author: OPD Working Group
Publisher: Seattle ; Toronto : Hogrefe & Huber
ISBN:
Category : Medical
Languages : en
Pages : 228
Book Description
The diagnosis of mental and psychosomatic disorders is currently dominated by operationalized systems of diagnosis, the most important of which are DSM-IV and ICD-10. Unfortunately, psychodynamic aspects were neglected during this purely phenomenology-based operationalization. And at the same time, psychoanalytical diagnostics (in the stricter sense of the term) has remained full of contradictions. This book aims to resolve this dilemma. It presents an operationalized psychodynamic approach to diagnosis, based on a multiaxial system. The Operationalized Psychodynamic Diagnostics (OPD) system is based on five axes: I = Experience of illness and prerequisites for treatment; II = Interpersonal relations; III = Conflicts; IV = Structure; and V = Mental and psychosomatic disorders. It is this Vth axis that allows the OPD diagnosis to be related to the ICD-10 and DSM-IV classifications. A diagnostic questionnaire and assessment forms (reprinted in the book) simplify the use of the OPD in practice.
Publisher: Seattle ; Toronto : Hogrefe & Huber
ISBN:
Category : Medical
Languages : en
Pages : 228
Book Description
The diagnosis of mental and psychosomatic disorders is currently dominated by operationalized systems of diagnosis, the most important of which are DSM-IV and ICD-10. Unfortunately, psychodynamic aspects were neglected during this purely phenomenology-based operationalization. And at the same time, psychoanalytical diagnostics (in the stricter sense of the term) has remained full of contradictions. This book aims to resolve this dilemma. It presents an operationalized psychodynamic approach to diagnosis, based on a multiaxial system. The Operationalized Psychodynamic Diagnostics (OPD) system is based on five axes: I = Experience of illness and prerequisites for treatment; II = Interpersonal relations; III = Conflicts; IV = Structure; and V = Mental and psychosomatic disorders. It is this Vth axis that allows the OPD diagnosis to be related to the ICD-10 and DSM-IV classifications. A diagnostic questionnaire and assessment forms (reprinted in the book) simplify the use of the OPD in practice.
Psychodynamic Coaching and Supervision for Executives
Author: Thomas Kretschmar
Publisher: Routledge
ISBN: 1000423646
Category : Psychology
Languages : en
Pages : 160
Book Description
Thomas Kretschmar and Andreas Hamburger provide an important overview of psychodynamic work in companies, presenting different viewpoints and explaining key psychoanalytic terms and techniques for coaching and supervision. Written in the form of a dialogue between Kretschmar, an entrepreneur, and Hamburger, a psychoanalyst, the book provides unique insight into psychodynamic coaching and supervision. Psychodynamic Coaching and Supervision for Executives begins with an overview of coaching, psychodynamic approaches, the unconscious and relevant psychoanalytic theory. Kretschmar and Hamburger then consider Operationalized Psychodynamic Diagnosis (OPD) in business, assess current research into coaching and supervision and present a selection of key case studies. At the end of each chapter, the authors compare their positions, giving important contextual information, exploring objections, complications and improvements, and providing a precise summary of the topic. This book will be an illuminating guide for therapists and professionals who wish to learn how psychoanalytic theory and practice can be used for coaching, counseling and supervision in an organizational context.
Publisher: Routledge
ISBN: 1000423646
Category : Psychology
Languages : en
Pages : 160
Book Description
Thomas Kretschmar and Andreas Hamburger provide an important overview of psychodynamic work in companies, presenting different viewpoints and explaining key psychoanalytic terms and techniques for coaching and supervision. Written in the form of a dialogue between Kretschmar, an entrepreneur, and Hamburger, a psychoanalyst, the book provides unique insight into psychodynamic coaching and supervision. Psychodynamic Coaching and Supervision for Executives begins with an overview of coaching, psychodynamic approaches, the unconscious and relevant psychoanalytic theory. Kretschmar and Hamburger then consider Operationalized Psychodynamic Diagnosis (OPD) in business, assess current research into coaching and supervision and present a selection of key case studies. At the end of each chapter, the authors compare their positions, giving important contextual information, exploring objections, complications and improvements, and providing a precise summary of the topic. This book will be an illuminating guide for therapists and professionals who wish to learn how psychoanalytic theory and practice can be used for coaching, counseling and supervision in an organizational context.
Operationalized Psychodynamic Diagnostics OPD-2
Author: Matthias von der Tann
Publisher: Hogrefe Publishing
ISBN:
Category : Psychology
Languages : en
Pages : 442
Book Description
OPD-2 is a new edition of the multiaxial diagnostic system for psychodynamically oriented therapists and psychiatrists, now with practical tools and procedures for treatment planning and for measuring change.Operationalized Psychodynamic Diagnosis (OPD) is a form of multiaxial diagnostic and classification system based on psychodynamic principles, analogous to those based on other principles such as DSM-IV and ICD-10. The OPD is based on five axes: I - experience of illness and prerequisites for treatment, II - interpersonal relations, III - conflict, IV - structure, and V - mental and psychosomatic disorders (in line with Chapter V (F) of the ICD-10). After an initial interview lasting 1-2 hours, the clinician (or researcher) can evaluate the patient's psychodynamics according to these axes and enter them in the checklists and evaluation forms provided. The new version, OPD-2, has been developed from a purely diagnostic system to include a set of tools and procedures for treatment planning and for measuring change, as well as for determining the appropriate main focuses of treatment and developing appropriate treatment strategies.
Publisher: Hogrefe Publishing
ISBN:
Category : Psychology
Languages : en
Pages : 442
Book Description
OPD-2 is a new edition of the multiaxial diagnostic system for psychodynamically oriented therapists and psychiatrists, now with practical tools and procedures for treatment planning and for measuring change.Operationalized Psychodynamic Diagnosis (OPD) is a form of multiaxial diagnostic and classification system based on psychodynamic principles, analogous to those based on other principles such as DSM-IV and ICD-10. The OPD is based on five axes: I - experience of illness and prerequisites for treatment, II - interpersonal relations, III - conflict, IV - structure, and V - mental and psychosomatic disorders (in line with Chapter V (F) of the ICD-10). After an initial interview lasting 1-2 hours, the clinician (or researcher) can evaluate the patient's psychodynamics according to these axes and enter them in the checklists and evaluation forms provided. The new version, OPD-2, has been developed from a purely diagnostic system to include a set of tools and procedures for treatment planning and for measuring change, as well as for determining the appropriate main focuses of treatment and developing appropriate treatment strategies.
Psychodynamic Formulation
Author: Deborah L. Cabaniss
Publisher: John Wiley & Sons
ISBN: 1118557298
Category : Medical
Languages : en
Pages : 243
Book Description
How do our patients come to be the way they are? What forces shape their conscious and unconscious thoughts and feelings? How can we use this information to best help them? Constructing psychodynamic formulations is one of the best ways for mental health professionals to answer questions like these. It can help clinicians in all mental health setting understand their patients, set treatment goals, choose therapeutic strategies, construct meaningful interventions and conduct treatment. Despite the centrality of psychodynamic formulation to our work with patients, few students are taught how to construct them in a clear systematic way. This book offers students and practitioners from all fields of mental health a clear, practical, operationalized method for constructing psychodynamic formulations, with an emphasis on the following steps: DESCRIBING problems and patterns REVIEWING the developmental history LINKING problems and patterns to history using organizing ideas about development. The unique, up-to-date perspective of this book integrates psychodynamic theories with ideas about the role of genetics, trauma, and early cognitive and emotional difficulties on development to help clinicians develop effective formulations. Psychodynamic Formulation is written in the same clear, concise style of Psychodynamic Psychotherapy: A Clinical Manual (Wiley 2011). It is reader friendly, full of useful examples, eminently practical, suitable for either classroom or individual use, and applicable for all mental health professionals. It can stand alone or be used as a companion volume to the Clinical Manual.
Publisher: John Wiley & Sons
ISBN: 1118557298
Category : Medical
Languages : en
Pages : 243
Book Description
How do our patients come to be the way they are? What forces shape their conscious and unconscious thoughts and feelings? How can we use this information to best help them? Constructing psychodynamic formulations is one of the best ways for mental health professionals to answer questions like these. It can help clinicians in all mental health setting understand their patients, set treatment goals, choose therapeutic strategies, construct meaningful interventions and conduct treatment. Despite the centrality of psychodynamic formulation to our work with patients, few students are taught how to construct them in a clear systematic way. This book offers students and practitioners from all fields of mental health a clear, practical, operationalized method for constructing psychodynamic formulations, with an emphasis on the following steps: DESCRIBING problems and patterns REVIEWING the developmental history LINKING problems and patterns to history using organizing ideas about development. The unique, up-to-date perspective of this book integrates psychodynamic theories with ideas about the role of genetics, trauma, and early cognitive and emotional difficulties on development to help clinicians develop effective formulations. Psychodynamic Formulation is written in the same clear, concise style of Psychodynamic Psychotherapy: A Clinical Manual (Wiley 2011). It is reader friendly, full of useful examples, eminently practical, suitable for either classroom or individual use, and applicable for all mental health professionals. It can stand alone or be used as a companion volume to the Clinical Manual.
Psychodynamic Treatment of Depression
Author: Fredric N. Busch
Publisher: American Psychiatric Pub
ISBN: 1615370692
Category : Medical
Languages : en
Pages : 244
Book Description
Psychodynamic Treatment of Depression addresses the use of psychodynamic psychotherapy, both alone and in combination with cognitive-behavioral, interpersonal, and medication treatments, as a method for reducing the psychological vulnerabilities that may predispose patients to persistent symptoms or recurrence of depression. Thoroughly revised and with new material, the second edition reflects changes codified in the DSM-5 classification and is intended for use by students, residents, or clinicians who are trained in the practice of psychotherapy. The authors' extensive clinical experience is thoroughly mined to provide techniques for tailoring the psychodynamic psychotherapeutic approach to patients with depression, and important topics such as narcissistic injury and vulnerability, guilt, defense mechanisms, and suicidality are addressed. The book is written in an accessible style and structured logically to support the acquisition and enhancement of psychotherapeutic skills through the systematic exploration of the psychodynamic model of depression. The volume's noteworthy content and features are many: Just as patients' responses to medications vary, responses to particular therapeutic interventions are different in different patients. Accordingly, the authors locate psychodynamic psychotherapy within the context of current treatments for depression, including indications and contraindications. A multitude of detailed and compelling clinical vignettes clearly illustrate the dynamics and techniques and facilitate learning across diverse clinical roles and practice settings. A chapter on psychodynamic approaches to depression with comorbid personality disorder has been added to the new edition, because these disorders have been found to have an adverse effect on treatment outcome, including diminished response to antidepressants, reduced adherence to treatment, and longer time period to achieve remission. There is a growing evidence base for the effectiveness of psychodynamic psychotherapy, both alone and in tandem with other treatment modalities. Psychodynamic Treatment of Depression offers a robust model of psychodynamic therapy for depression and the detailed strategies and techniques clinicians need to improve outcomes with this significant patient group.
Publisher: American Psychiatric Pub
ISBN: 1615370692
Category : Medical
Languages : en
Pages : 244
Book Description
Psychodynamic Treatment of Depression addresses the use of psychodynamic psychotherapy, both alone and in combination with cognitive-behavioral, interpersonal, and medication treatments, as a method for reducing the psychological vulnerabilities that may predispose patients to persistent symptoms or recurrence of depression. Thoroughly revised and with new material, the second edition reflects changes codified in the DSM-5 classification and is intended for use by students, residents, or clinicians who are trained in the practice of psychotherapy. The authors' extensive clinical experience is thoroughly mined to provide techniques for tailoring the psychodynamic psychotherapeutic approach to patients with depression, and important topics such as narcissistic injury and vulnerability, guilt, defense mechanisms, and suicidality are addressed. The book is written in an accessible style and structured logically to support the acquisition and enhancement of psychotherapeutic skills through the systematic exploration of the psychodynamic model of depression. The volume's noteworthy content and features are many: Just as patients' responses to medications vary, responses to particular therapeutic interventions are different in different patients. Accordingly, the authors locate psychodynamic psychotherapy within the context of current treatments for depression, including indications and contraindications. A multitude of detailed and compelling clinical vignettes clearly illustrate the dynamics and techniques and facilitate learning across diverse clinical roles and practice settings. A chapter on psychodynamic approaches to depression with comorbid personality disorder has been added to the new edition, because these disorders have been found to have an adverse effect on treatment outcome, including diminished response to antidepressants, reduced adherence to treatment, and longer time period to achieve remission. There is a growing evidence base for the effectiveness of psychodynamic psychotherapy, both alone and in tandem with other treatment modalities. Psychodynamic Treatment of Depression offers a robust model of psychodynamic therapy for depression and the detailed strategies and techniques clinicians need to improve outcomes with this significant patient group.