[Indication of psychoanalytic treatment for personality disorders]

The study investigates how a psychoanalytic institution reaches its aims by identifying different factors like diagnosis, sociodemographic characteristics of the patient, motivation of the psychoanalyst, and their impact on the indication-process.

38 patients diagnosed as having severe personality disorders and treated in a psychoanalytic outpatient clinic were compared with 49 patients who were referred for psychoanalytic treatment to a private practice.

Although the groups were similar regarding the severity of their problems, more comorbidity and a more stable professional life were found in the group referred to private practice. Patients who tend to distort their social life in order to maintain a fragile psychic balance are more likely to get institutional treatment. The psychoanalytic team-conference and discussion of unconscious object-relationship pattern had great impact on the process of giving correct indications.

The indication for psychoanalytic treatment does not correlate with personality disorder diagnosis or with the motivation of the therapist. Nevertheless, more differentiated, in clinical routine practicable instruments measuring reflective functioning, or the quality of object relationship have to be developed in order to give an adequate indication for psychoanalytic treatment.