[Psychotherapeutic day treatment of patients with severe personality disorders. Results from the first two years].

INTRODUCTION

A psychotherapeutic day treatment (DT) for patients with severe personality disorders (PD) was established in January 2003, consisting of five months of intensive psychodynamic based integrated therapy for 14 patients. This paper presents results from the first two years.

MATERIAL AND METHODS

53 patients were included in a five month combined group psychotherapeutic DT, including psychoeducation, cognitive, body, music/drawing and individual therapy. Semi-structured interviews were used to assess diagnosis (PSE, SCID-II). SCL-90-R, self-rating scales and GAF rating (s/f) were used before and after therapy. The design was naturalistic.

RESULTS

40 patients (34 women) completed the DT. Eight dropped out and five received another treatment. Before treatment: Average age 27(SD 6,5), mean GAF= 43 corresponding with unemployment, singles and social dysfunctions, high degree of self mutilation, suicide attempts, earlier hospitalisations and substance abuse. The most frequent diagnosis was borderline disorder 63%. There were co-morbidity with anxiety disorder 48% and depression 22%. Most importantly, we found a significant reduction in symptoms, significant increase in the level of function, reduction in self destructive behaviour, a pronounced reduction in hospitalisations and a relatively high degree of satisfaction with the treatment programme.

CONCLUSION

According to literature, effective treatment of patients with severe PD has to be long term, integrated, theoretical coherent and focused on compliance. Our study indicates that the intensive DT is effective and a good introduction to long term psychotherapy.