Psychiatr. Pol. 2019; 53(4): 883–899

DOI: https://doi.org/10.12740/PP/89795

Paweł Rodziński, Anna Ostachowska, Katarzyna Cyranka,
Krzysztof Rutkowski, Jerzy A. Sobański,
Anna Citkowska-Kisielewska, Edyta Dembińska, Michał Mielimąka

Nerwicowe cechy osobowości i związane z nimi dysfunkcjonalne postawy pacjentów jako czynniki predysponujące do wystąpienia myśli samobójczych pod koniec intensywnej psychoterapii

Aim. To determine the relationshipsbetween personality traits typical for neurotic disorders and dysfunctional attitudes declared by patients without suicidal ideations (SI) prior to treatment and SI at the end of an intensive psychotherapy with a predominant psychodynamic approach in the day hospital for neurotic, behavioral, or personality disorders.
Material and method. KO “O” Symptom Checklist for assessing SI, Neurotic Personality Questionnaire KON-2006 for evaluation of neurotic personality characteristics and patients’ attitudes, and a Life Questionnaire, all completed by a group of 680 patients of a day psychotherapy ward, treated for the first time. Statistical analysis encompassed 466 non-SI patients, 4% of whom had SI at the end of treatment.
Results. A number of attitudes have been identified in patients who were significantly predisposed to SI at the end of intensive psychotherapy: physical aggression towards relatives (p < 0.001), grandiose fantasies (p = 0.043), resignation tendencies (p = 0.022), resignation feeling associated with the experience of loss of life opportunities (p = 0.037), and being guided mainly by intuition (p = 0.035). It was also observed that declaring certain attitudes was significantly associated with less than average chance of SI at the end of treatment.
Conclusions. In patients who declared these attitudes, there was a higher risk of SI at the end of the psychotherapy cycle than in the remaining patients (10–30% vs. 4%), which indicates the presence of specific dysfunctions of personality, in the case of which intensive psychotherapeutic work requires particular caution –it can trigger emotional stress leading to SI instances. It can be assumed that SI are the result of the reconstruction of defense mechanisms while working on insight, confrontation with the causes and consequences of the patients’ own physical aggression towards the loved ones, the realization of the size of their grandiose thinking and the insight into its function, and the insight into the causes of resignation attitudes.

ISSN 0033-2674 (PRINT)

ISSN 2391-5854 (ONLINE)

Psychiatria Polska
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