Addition of time-limited psychotherapy to medical treatment in a general medical clinic. Results at one-year follow-up.

ABSTRACT

This study compares 72 patients screened for significant emotional problems and treated only by internists of a general medical clinic with 62 patients also treated by internists but completing in addition 10 weekly psychotherapeutic visits. Forty-one patients did not keep their initial appointments and 69 patients dropped out of treatment but are not considered in this report. These patients, from inner-city Baltimore, were socially and economically a highly disadvantaged group. At intake, the 62 patients who completed psychotherapy and the 72 patients treated only by internists were equal demographically and in diagnosed physical illnesses. The two groups were approximately equal in the extent of emotional disturbance. All patients were followed up at 4 months and 1 year after intake. Methods of evaluation included a 7-point self-report of global improvement, the 58-item Hopkins Symptom Checklist, the primary target complaint, scaled clinical estimates of psychosocial adjustment, and scaled data from systematic review of medical charts. Significantly more patients undergoing the psychotherapy remained improved at 1-year follow-up, independent of age, sex, degree of disability, diagnosed medical illnesses, level of emotional disturbance, and employment status. While there was evidence of a common denominator to therapeutic results in both groups, the data strongly suggests specific effects of psychotherapy.