Jerzy A. Sobański

Dynamika globalnego nasilenia objawów zaburzeń nerwicowych podczas intensywnej psychoterapii na oddziale dziennym                 77

Global neurotic symptoms index dynamics during intensive psychotherapy in a day hospital setting    77

Summary

Aim: Analysis of the dynamics of the global neurotic symptom level during intensive integrative psychotherapy in a day-hospital setting, and its relation to therapy outcome. Method: 4345 symptom check-lists "0", filled in by 319 patients treated in day-hospital in the years 1990-1998 were analysed. The studied group consisted in 235 women and 84 men with somatization disorders, generalized anxiety disorder, dissociative disorders and a combination of those mentioned above. Results: In groups of patients with different therapy outcome, different types of global symptom level sequential changes were observed. Some phenomena like weeks of invariant symptom level ("a plateau") occurred with a different frequency related to the final therapy outcome. During treatment, the global symptom level fall below 200 pts in women and 165 in men often preceded global symptom exacerbations and occurred even in therapies with non-beneficial final results. Conclusion: Some traits of global neurotic symptom level dynamics may be understood as additional markers of beneficial or non-beneficial therapy processes. Sequences of symptom decrease, as well as sequences of short increase were connected with better therapy results. Weekly filled in symptom check-lists may be useful for monitoring of the psychotherapy process, but a decrease of the global symptom level (OWK) to values typical for healthy population does permit one to consider a patient as a "cured" one. Even a decrease of OWK below 100/82 pts is not always connected to a further maintaining of a global symptom level in the healthy subject domain.