INPATIENT PSYCHOTHERAPY OF PSYCHOSES - A PRE POST AND FOLLOW-UP PSYCHOLOGICAL OUTCOME STUDY/

The study was conducted to assess the efficiency of human-structural p sychoanalytic psychotherapy with psychotic-structured patients of the Dynamic-Psychiatric Hospital Menterschwaige, Munich, at the time of ad mission, discharge and follow-up which ranged from 1 to 7 years. Some significant variables of personality were measured (especially the fun ctions of aggression, anxiety, ego-boundaries and narcissism), as well as variables of feeling, behavior, quality of life and the symptomato logy of the patients. The hospital is working with the concept of Dyna mic Psychiatry of Gunter Ammon and offers a spectrum of verbal and non -verbal therapeutic methods - combined with as low doses of psychotrop ic drugs as possible - in order not only to improve symptomatology, bu t also to achieve changes of personality and human structure. We inves tigated 57 patients who had completed psychometrical testing at admiss ion (t1), discharge (t2) and follow-up (t3): The Ego Structure Test (I ch-Struktur-Test nach Ammon) ISTA, the MMPI short version), the Giesse n Test (GT) and a questionnaire which checks for changes in feeling an d behavior (Veranderungsfragebogen des Erlebens und Verhaltens, VEV). Statistical analysis (MANOVA) or data from all sub-scales in the cours e of measurement shows a significant positive effect of therapy. 21 ou t of 26 scales with clinical relevance improve significantly during th erapy ttl to t2) and keep stable in the follow-up of 1 to 7 years. A f urther improvement after discharge from the clinic (t2 to t3) is shown in 6 scales. The hypothesis that psychotherapy has long-term positive effects is supported by changes in VEV (p=0.01). The results are conf irmed by the questionnaires completed by 104 former patients with psyc hotic structure in the same period of treatment and an average follow- up of 4,1 years. In the second part of the study questions of differen tial diagnosis between patients with schizophrenia and narcissistic de pression concerning course and outcome of therapy are discussed.