Course of symptom severity and prediction of outcome in inpatient psychotherapy

Objectives: The study looks for typical curves of symptom development in inpatients and investigates the influence of initial remoralisation and terminal improvement on the global therapy outcome. Methods: 71 psychotherapy inpatients (affective, anxiety, eating and personality disorders; average treatment duration 11.9 weeks) gave weekly self-reports on symptom severity (BSI, Derogatis, 1983) and had a complete outcome evaluation. Regression parameters of the symptom curves were taken for correlational and path analytic calculations. Results: Initial symptom alleviation is able to predict better global outcome. However there is a relevant subgroup of patients which has a good outcome despite an initial deterioration. Conclusions: Initial remoralisation predicts better outcome but is not a necessary condition. The results partly call into question the group statistical dose-response-curves. Further studies should test the influence of other process parameters (group cohesion, therapeutic alliance etc.) on the course of treatment.