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<p>This study investigates the relationship between symptom changes and psychiatric hospitalizations during long-term psychodynamic psychotherapy for clinically complex patients with multiple diagnoses, high disability rates, and extensive prior-treatment histories.&#xa0;The study includes 88 patients with complex mental health needs receiving twice-weekly psychodynamic psychotherapy in Israeli public mental health centers. Psychiatric hospitalizations (frequency and duration) and symptoms (BDI, SCL-90, OQ-45) were tracked at six-month intervals using medical records and self-report measures. Change-score correlations were assessed using Structural Equation Modeling to analyze cross-lagged relationships across six measurement points.&#xa0;No significant correlation was found between symptom and hospitalization change scores. However, cross-lagged analysis revealed that hospitalization in one period negatively predicted subsequent BDI scores, with similar inverse relationships between hospitalization frequency and SCL-90 scores.&#xa0;Symptom improvement and reduced hospitalizations were not directly correlated, though hospitalizations predicted subsequent symptom reduction in specific measures. This suggests distinct yet related mechanisms, highlighting the need to evaluate both domains independently in complex psychiatric cases.</p>

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Do psychiatric hospitalization and symptoms change together in treatment, and do they predict each other?

  • 期刊论文

  • 发表日期：

    2025年7月31日

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  • Refael Yonatan-Leus,
  • Maayan Abargil,
  • Ron Finkenberg,
  • Ilan Amir,
  • Gaby Shefler

摘要

This study investigates the relationship between symptom changes and psychiatric hospitalizations during long-term psychodynamic psychotherapy for clinically complex patients with multiple diagnoses, high disability rates, and extensive prior-treatment histories. The study includes 88 patients with complex mental health needs receiving twice-weekly psychodynamic psychotherapy in Israeli public mental health centers. Psychiatric hospitalizations (frequency and duration) and symptoms (BDI, SCL-90, OQ-45) were tracked at six-month intervals using medical records and self-report measures. Change-score correlations were assessed using Structural Equation Modeling to analyze cross-lagged relationships across six measurement points. No significant correlation was found between symptom and hospitalization change scores. However, cross-lagged analysis revealed that hospitalization in one period negatively predicted subsequent BDI scores, with similar inverse relationships between hospitalization frequency and SCL-90 scores. Symptom improvement and reduced hospitalizations were not directly correlated, though hospitalizations predicted subsequent symptom reduction in specific measures. This suggests distinct yet related mechanisms, highlighting the need to evaluate both domains independently in complex psychiatric cases.