Am J Psychiatry 1994; 151:586-590
Copyright © 1994 by American Psychiatric Association
Characteristics of psychoanalytic patients under a nationalized health plan: DSM-III-R diagnoses, previous treatment, and childhood trauma
N Doidge, B Simon, LA Gillies and R Ruskin
Clarke Institute of Psychiatry, Toronto, Ont., Canada.
OBJECTIVE: This article reports the results of a survey to collect data on
the characteristics of patients in psychoanalysis under a nationalized
health insurance scheme. METHOD: A questionnaire, to be answered
anonymously, was sent to all 174 accredited psychoanalysts in Ontario,
Canada. Part 1 of the questionnaire consisted of 38 questions on the
analyst's pattern of practice. Part 2, also to be filled out by the
analyst, consisted of 452 questions on the demographic characteristics,
childhood traumas, DSM-III-R diagnoses, and indications for psychoanalysis
of each of the analyst's patients. RESULTS: One hundred seventeen analysts
responded--a survey response rate of 67%--with data on 580 patients.
Fifty-nine percent (N = 344) of patients were women, and 41% (N = 236) were
men. Eighty-two percent had attempted other forms of treatment, including
briefer forms of psychotherapy and medication, prior to psychoanalysis.
During childhood, 23% had had traumatic separations, 23% had been sexually
abused, 22% had been physically abused, and 21% had had a parent or sibling
die. The mean number of adult psychiatric disorders at the beginning of
analysis was four, and the mode was two. CONCLUSIONS: In a nationalized
health insurance scheme, the psychoanalytic patients were mostly women,
they had high rates of trauma and psychopathology, and they had attempted
other forms of briefer treatment before resorting to psychoanalysis.
