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The large-scale outcome study (1004 patients) was carried out at the Institute of Psychogenic Illness in Berlin. It was originally published by Annemarie Dührssen in 1962. The present paper is a summary of the research.
The study was funded by the insurance company Allgemeine Ortskrankenkasse [AOK] in Berlin. Insurance cover is compulsory in Germany, and employers usually contribute to their employees’ insurance cover. In the case of the AOK, very low contributions are payable by employees. The unemployed are also covered by the AOK. Thus the AOK system of insurance in Germany seems very much like the British National Health Service. Dührssen's study is impressive, but the presentation of it is rather confusing. I have therefore not only summarised it but reorganised it into a more conventional shape. The other problem with the study is that it is rather ‘historical’ — the references are from the 1940s.
This research study on the outcome of psychoanalytic psychotherapy was commissioned by the insurance company in order to establish the effectiveness of this kind of therapy. It was one paper in a series of research projects of this type, including not only data on therapy outcome, but also follow-up data.
Dührssen introduced the study with a list of the essential conditions that ought to be met by an outcome study. She listed six criteria:
The type of psychotherapy investigateted must be defined; and appropriate selection of patients for treatment as well as the standard of treatment must be ensured, patients must be selected appropriately; and the standard of treatment must be ensured.
The number of cases has to be large enough to ensure a statistically significant difference at evaluation.
The outcome statistics should be drawn as far as possible from the same setting. (Those from different settings cannot easily be compared.)
A statistically significant percentage of patients must be available for follow-up.
There must be a sufficiently long period o