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

The study was conducted to assess the efficiency of human-structural psychoanalytic psychotherapy with psychotic-structured patients of the Dynamic-Psychiatric Hospital Menterschwaige, Munich, at the time of admission, discharge and follow-up which ranged from 1 to 7 years. Some significant variables of personality were measured (especially the functions of aggression, anxiety, ego-boundaries and narcissism), as well as variables of feeling, behavior, quality of life and the symptomatology of the patients. The hospital is working with the concept of Dynamic Psychiatry of Gunter Ammon and offers a spectrum of verbal and non-verbal therapeutic methods - combined with as low doses of psychotropic drugs as possible - in order not only to improve symptomatology, but also to achieve changes of personality and human structure. We investigated 57 patients who had completed psychometrical testing at admission (t1), discharge (t2) and follow-up (t3): The Ego Structure Test (Ich-Struktur-Test nach Ammon) ISTA, the MMPI short version), the Giessen Test (GT) and a questionnaire which checks for changes in feeling and behavior (Veranderungsfragebogen des Erlebens und Verhaltens, VEV). Statistical analysis (MANOVA) or data from all sub-scales in the course of measurement shows a significant positive effect of therapy. 21 out of 26 scales with clinical relevance improve significantly during therapy ttl to t2) and keep stable in the follow-up of 1 to 7 years. A further 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 confirmed by the questionnaires completed by 104 former patients with psychotic 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 differential diagnosis between patients with schizophrenia and narcissistic depression concerning course and outcome of therapy are discussed.