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Psychosomatic Medicine 13:83-105 (1951)
© 1951 American Psychosomatic Society

Evaluation of Psychotherapy

With a Follow-Up Study of 62 Cases of Anxiety Neurosis

HENRY H. W. MILES M.D.1, EDNA L. BARRABEE M.S.1, and JACOB E. FINESINGER M.D.2

1 Department of Neurology and Psychiatry, Harvard Medical School; the Department of Psychiatry, Massachusetts General Hospital, and the Massachusetts General Hospital Branch of the Hall-Mercer Hospital, Boston, Massachusetts
2 Department of Neurology and Psychiatry, Harvard Medical School; the Department of Psychiatry, Massachusetts General Hospital, and the Massachusetts General Hospital Branch of the Hall-Mercer Hospital, Boston, Massachusetts; School of Medicine, University of Maryland, Baltimore

The problem of evaluation of treatment of the psychoneuroses was discussed, with a review and criticism of previous reports. These have not been comparable to one another, largely due to lack of sufficiently detailed clinical data and precisely defined criteria.

A follow-up study was carried out upon 62 patients with anxiety neurosis, two to twelve years after intramural psychotherapy.

When evaluated by explicit criteria, 23 per cent of the group were found to be markedly improved, 35 per cent were definitely better, and 42 per cent were considered essentially unchanged. There was a close correlation between our evaluations and the patients' own self-evaluations.

In no case was previously unrecognized medical or surgical disease later found to be associated with the symptoms and no case had later become psychotic.

Analysis of the available anamnestic material suggested that a number of elements were related to the course of the illness. Among these were the patient's intelligence, his early home situation, early neurotic traits, severity of the clinical symptoms, and capacity for achieving insight. Almost the whole, group had been treated by relatively inexperienced therapists but a slightly higher percentage of patients in the improved categories had been treated by the more experienced psychiatrists.

The scope of the study was limited by the type and amount of information available in the case records, but our findings were consistent with dynamic theoretical concepts. It is believed that further progress in solving the problem awaits more detailed investigations and methodologic advances in the analysis of data.

Submitted on May 8, 1950






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Copyright © 1951 by the American Psychosomatic Society