[Treatment outcome of psychodynamic trauma therapy in an inpatient setting]

Chronic traumatization with the beginning in childhood may result in a number of additional problems not included in the diagnosis of Posttraumatic Stress Disorder (PTSD). The efficacy of a three-stage psychodynamically oriented inpatient treatment program (PITT) and the role of chronic childhood threat on treatment outcome was investigated.

A six-week treatment group of 84 inpatients were compared with 43 wait-list controls with "treatment as usual" (outpatient psychotherapy or psychiatric treatment in the meanwhile). Using measures on PTSD, dissociation, depression, selfsoothing, anxiety and somatization, assessments were made at admission, at discharge and 6 months postdischarge. Assessments for the outpatient control group were made at comparable time spans.

In the treatment group significant improvements emerged on all investigated parameters (depression, intrusion, avoidance, anxiety, somatization, and self-soothing) from baseline to discharge, many of which could be maintained over a period for 6 months. PITT especially supports the stabilization of patients with experiences of childhood chronic threat and insecure attachment. Gains in depression, anxiety, somatization, and self-soothing were also significant in comparison to the control group.

Our results suggest that PITT offered on an inpatient basis is an effective treatment for severely traumatized patients that gives impetus to change which should be supplemented with further trauma-specific outpatient therapy to stabilize gains.