Nickel Cerstin, Tritt Karin, Kettler Christian, Lahmann Claas, Loew Thomas, Rother Wolfhardt, Nickel Marius
Clinic for Psychosomatic Medicine, Inntalklinik, Simbach/Inn, Germany.
Wien Klin Wochenschr. 2005 May;117(9-10):359-63. doi: 10.1007/s00508-005-0334-y.
Whether the primary motivation for entering therapy significantly influences the results of inpatient psychotherapeutic treatment is subject to debate. The purpose of this study was to examine this question in women with generalized anxiety disorder. The monitored results from 54 female inpatients (29 who were highly motivated to enter therapy and 25 who were minimally motivated) were compared. The questionnaire for measuring psychotherapy motivation (FMP), the symptom checklist (SCL-90-R) and the questionnaire for measuring change of experience and behavior (VEV) were used to assess motivation and results of treatment. The patients were tested at admission and after the fourth and sixth weeks of therapy, at which time the patients with high primary motivation showed a significantly more marked reduction of anxiety symptoms (SCL-90-R, P < 0.01). These patients also had better test results on the VEV (P < 0.01). However, both quantitative and qualitative improvements in motivation for therapy were observed among the less motivated patients, and this improvement did not differ from that of the highly motivated group on most scales of the FMP (P < 0.05 to P = 0.43). Highly motivated patients with generalized anxiety disorder can profit significantly more from inpatient psychosomatic treatment than those who have less primary motivation. However, less motivated patients can show significant positive changes in developing motivation for therapy, as well as in the final results of treatment. Establishing and developing motivation prior to hospitalization might contribute to more efficient and cost-effective clinical treatment.
进入治疗的主要动机是否会显著影响住院心理治疗的效果,这一问题仍存在争议。本研究的目的是针对广泛性焦虑症女性患者探讨这一问题。比较了54名女性住院患者(29名有强烈治疗动机和25名治疗动机微弱者)的监测结果。使用测量心理治疗动机的问卷(FMP)、症状清单(SCL - 90 - R)以及测量经验和行为变化的问卷(VEV)来评估治疗动机和治疗效果。在患者入院时、治疗第四周和第六周后进行测试,此时有较高初始动机的患者焦虑症状(SCL - 90 - R)的减轻更为显著(P < 0.01)。这些患者在VEV上的测试结果也更好(P < 0.01)。然而,治疗动机较弱的患者在治疗动机方面在数量和质量上均有改善,且在FMP的大多数量表上,这种改善与高动机组并无差异(P < 0.05至P = 0.43)。患有广泛性焦虑症的高动机患者比初始动机较弱的患者能从住院身心治疗中显著获益更多。然而,动机较弱患者在治疗动机的发展以及治疗最终结果方面也能表现出显著的积极变化。在住院前确立并培养动机可能有助于实现更高效且具成本效益的临床治疗。