[Effect of the degree of instability during therapy on the treatment outcome of in-patient psychotherapy of obsessive-compulsive disorder].
BACKGROUND
The present study evaluates a central hypothesis of synergetic psychotherapy research according to which a marked instability in the psychotherapeutic process is associated with high response rates.


METHODS
14 patients with obsessive-compulsive disorder (OCD) completed an eight-week in-patient course of multimodal behavior therapy with exposure exercises. The instability during the course of the therapy was recorded by daily selfassessment by the patient using the Synergetic Navigation System (SNS), an Internet-based real-time monitoring procedure.


RESULTS
There was a negative correlation between the degree of the instability and the percentage reduction in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) (r = -0.395; P = 0.199), the "Global Severity Index" (GSI) of the symptom check-list (SCL-90-R) (r = -0.718; P = 0.013), the scale value for obsessive-compulsiveness in the SCL-90-R (r = -0.782; P = 0.004) and the remaining sub-scales of this data-gathering instrument.


CONCLUSIONS
An unstable progress of the psychotherapy causes a smaller reduction in symptoms than a stable one. The contradiction relative to the study hypothesis is possibly based on the special features of OCD, with a high level of patient insecurity when anticipating new, non-obsessive-compulsive ways of thought and behavior. The relationships between instability and reduction in symptoms appear to be diagnosis-specific.
Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Wien, Österreich.
Markus
M
Dold
Ulrike
U
Demal
Gerhard
G
Lenz
Günter
G
Schiepek
Martin
M
Aigner
D003131:Combined Modality Therapy; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D016896:Treatment Outcome