This article describes the results of a one year follow-up investigation of patients suffering from psychiatric and mental diseases and psycho-social problems who were seen in general practice or by private practising psychiatrists and the psychiatric outpatient hospital clinic in a Danish county. 40-50% of the patients concluded treatment within the first year. The general practitioner and the private practising psychiatrist saw 10% of the patients more than 13 times. In the outpatient hospital clinic, 10% of the patients were seen more than 29 times. A psychotherapeutic approach to treatment was employed for 54-90% of the cases. Psychopharmacological medication was administered to 54-60% of the patients. Where patients in general practice and in the outpatient clinic were concerned, treatment in an emergency open unit and treatment in sheltered environments was required and supervision was necessary for 1/4 of the cases. The investigation demonstrates the role of the general practitioner in treatment and referral. After one year 25% of the patients were referred for other treatment. The general practitioner, private practicing psychiatrist and outpatient clinic treat different groups of psychiatric patients and work somewhat independently of one another.
Only few research studies on psychotherapy in Denmark have been published. Our investigation summarizes the results of the psychotherapeutic treatment given 1982-1987 at the Outpatient Clinic for the treatment of Neuroses, Psychiatric Hospital in Aarhus. 45% of the 803 patients who were referred to the clinic commenced psychotherapy. 30% of the patients were students aged 20-39 years. Diagnostically, 60% of the patients had neurotic disturbances, 20% were borderline personality organised and the remainder included patients with higher level personality disturbances and psychotic patients. 85% of the patients were on the waiting list for less than six months. 42% of the men and 52% of the women had more than 25 psychotherapy sessions. 80% had individual psychotherapy. According to the opinions of the psychotherapists, 48% of the male patients and 44% of the female patients gained considerably from the treatment. Those who were helped by the treatment received treatment significantly longer than those in whom the condition did not change or deteriorated. The results of the investigation indicate the need for a prospective qualitative study of the therapeutic alliance, and this investigation is in preparation.
A Danish centre contributed 12 cases to a Nordic multicentre investigation concerning the psychotherapy of psychoses. Patients admitted consecutively to the psychiatric hospital with the diagnoses of schizophrenia, schizophreniform psychosis or schizoaffective psychosis were offered psychotherapy at least once weekly for two years in addition to the other treatment modalities administered. In the Danish design, the process of supervision in relation to the processes of psychotherapy was investigated. In the present article, examples are presented illustrating how core psychotic mechanisms in the patients are reflected not only in process-facilitating but also in process inhibiting psychotherapeutic interventions. The data of the investigation are these interventions which are written down prospectively in the summaries of the supervision.
The article describes the psychiatric outpatient treatment service in the catchment area of the county of Roskilde in Denmark. Eighty-four general practitioners, ten private practising psychiatric specialists and the psychiatric outpatient service at Roskilde Amts Sygehus Fjorden participated in a prospective cohort study based on questionnaires. This includes 404 patients from general practice, 326 from the psychiatric specialists and 166 from the psychiatric hospital. The patients' social conditions, demographic data, psychosocial problems, psychosocial strain, diagnoses, and the treatment are presented. Psychotics constitute 52% of the patients from the outpatient treatment service corresponding to 25% from specialist practice and 12% from general practice. The most common diagnoses at specialist level are neuroses and crises, in general practice, in addition, psychosomatic illness and depression without psychoses. The treatment for most of the patients is psychotherapy or in combination with psychopharmacology. Further acute psychiatric service and supervision are required. One year follow-up has been accomplished. Follow-up reviews after five and ten years are planned.