[A 50-year register follow-up of 112 patients with a classic diagnosis of neurosis].

INTRODUCTION

The study is a register follow-up on a group of patients with a diagnosis of neurosis according to the Danish psychiatric/psychoanalytical tradition. The study group consists of the 'hospital material' used by the late Erling Jacobsen, M.D., in his doctoral thesis of 1965.

MATERIALS AND METHODS

The cohort consists of 112 patients (30 males (26.8%) and 82 females (73.2%)) hospitalized in the years 1952 to 1957. These patients were suffering from anxiety neuroses, obsessive-compulsive states or hysterical neuroses. In an early phase of the study, a systematic review of all records was made in order to re-diagnose the patients according to DSM-III. The results presented in the study are therefore mainly based on the DSM-III categories.

RESULTS

The original categorization of patients into anxiety neurosis, obsessive-compulsive states or hysterical neurosis did not have any prognostic significance as to readmission or death. DSM-III diagnoses result in a similar picture. During follow-up a total of 67 patients died. There was a weak but insignificant excess mortality of 1.16 for men and 1.14 for women. Death by suicide was significantly increased for both sexes. Most suicides occurred relatively soon after discharge. Of all the 112 patients, 81.2% remained in the original diagnostic main category, while 14.3% received a psychosis diagnosis.

CONCLUSION

The neurosis diagnosis according to Danish psychiatric tradition appears rather stable. On the other side, a minor fraction of patients were later diagnosed as being psychotic. The opinion that 'real' neurotics could not be later re-diagnosed as non-neurotics has therefore not been confirmed.